Anatomic substrate for idiopathic left ventricular tachycardia
Anatomic substrate for idiopathic left ventricular tachycardia
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DOI：
10.1161/01.cir.93.3.497
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发表时间：
1996-02-01
期刊：
影响因子：
37.8
通讯作者：
Jackman, WM
中科院分区：
文献类型：
--
作者：
Thakur, RK;Klein, GJ;Jackman, WM
特发性左室性心动过速（ILVT）是一种独特的临床综合征，以QRS复合物伴右束-分支阻滞（RBBB）形态和左轴偏离为特征，在无结构性心脏病的患者中也表现出维拉帕米的特征性反应和心房诱导性。在左心室假肌腱已经描述了一个病人的左心室左心室假肌腱手术切除导致治愈。我们假设假肌腱是其他类似室性心动过速（VT）发生的原因。方法与结果我们对15例接受导管消融治疗ILVT的患者进行了经胸（TTE）和/或经食管（TEE）二维超声心动图检查。男性12例，女性3例，平均年龄31+/-12岁，平均症状持续时间11+/-9年。平均VT周期为360+/-70 ms，均为RBBB形态，左轴偏移。所有ILVT患者的心室大小、左室壁厚度和壁运动均正常。在所有ILVT患者中，TTE和/或TEE显示假肌腱从左心室游离壁后下延伸到左室间隔。5例假肌腱粗（最大厚度大于或等于2mm）， 5例假肌腱细(
Background Idiopathic left ventricular tachycardia (ILVT) characterized by QRS complexes with right bundle-branch block (RBBB) morphology and left axis deviation is a distinct clinical syndrome that also demonstrates a characteristic response to verapamil and inducibility from the atrium in patients without structural heart disease. A false tendon has been described in the left ventricle in a patient with ILVT in whom surgical resection of the false tendon resulted in cure. We hypothesized that the false tendon is responsible for the genesis of similar ventricular tachycardia (VT) in others.Methods and Results We performed transthoracic (TTE) and/or transesophageal (TEE) two-dimensional echocardiograms in 15 patients undergoing catheter ablation for ILVT. There were 12 men and 3 women (mean age, 31+/-12 years, with average symptom duration of 11+/-9 years). The mean VT cycle length was 360+/-70 ms, and all had RBBB morphology with left axis deviation. Cardiac chamber sizes, left ventricular wall thickness, and wall motion were normal in all ILVT patients. TTE and/or TEE demonstrated a false tendon extending from the posteroinferior left ventricular free wall to the left ventricular septum in all ILVT patients. The false tendons were thick (greater than or equal to 2 mm maximal thickness) in 5 patients and thin (