Inducible atrial flutter after the Mustard repair of complete transposition of the great arteries.
Inducible atrial flutter after the Mustard repair of complete transposition of the great arteries.
复制标题
大动脉完全转位芥末修复术后诱发心房扑动。
DOI：
10.1016/0002-9149(88)90299-8
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发表时间：
1988
期刊：
影响因子：
--
通讯作者：
Horowitz,LN
中科院分区：
文献类型：
--
作者：
Vetter,VL;Tanner,CS;Horowitz,LN
心房扑动是完全性大动脉转位（d-TGA）患者在Mustard修补术后常见的术后心律失常。通过电生理研究对60例接受Mustard修复的d-TGA患者进行了评价。33例（55%）有可诱导的持续性房扑;其中17例发生了自发性房扑临床发作（临床房扑组），16例未发生（非临床房扑组）。在17例临床诱导型房扑患者中，有6例（35%）首先在电生理实验室中记录了该疾病，随后出现自发性临床发作。用于确定心房激动序列和传导间期的导管内标测显示所有患者的心房内传导延迟伴低心房部位的迟发性激动。存在心房不应性的离散度，在临床房扑组中发现心房不应性的离散度更大。在有房扑临床发作的患者中，窦房结功能严重异常的程度明显更高。这些电生理异常和相关的心律失常可能使d-TGA患者易于猝死。
Atrial flutter is a common postoperative arrhythmia in patients with complete transposition of the great arteries (d-TGA) after the Mustard repair. Sixty patients with d-TGA who had the Mustard repair were evaluated by electrophysiologic studies. Thirty-three (55%) had inducible sustained atrial flutter; 17 of them developed spontaneous clinical episodes of atrial flutter (clinical atrial flutter group) and 16 did not (nonclinical atrial flutter group). In 6 of the 17 patients (35%) with clinical inducible atrial flutter, the condition was first documented in the electrophysiologic laboratory with subsequent development of spontaneous clinical episodes. Catheter endocardial mapping, used to determine atrial activation sequences and conduction intervals, revealed intraatrial conduction delays with late activation of the low atrial sites in all patients. Abnormalities of atrial refractoriness were present, with a greater dispersion of atrial refractoriness found in the clinical atrial flutter group. Severe abnormalities of sinus nodal function appeared to a significantly greater degree among patients who had clinical episodes of atrial flutter. These electrophysiologic abnormalities and associated arrhythmias may predispose patients with d-TGA to sudden death.