心筋梗塞の後の電気嵐のカテーテル切除が成功しました
Dietmar Bänsch1, Feifan Oyang, Matthias Antz
1Department of Cardiology, AK St. Georg, Hamburg, Germany.
Circulation
|December 10, 2003
まとめ
ラジオ周波数アブレーションは,心筋梗塞後の患者の薬剤耐性心室動脈不律を成功裏に治療しました. このカテーテル切除は,早発した心房の鼓動を標的とし,さらなる電気嵐を防止し,救済療法の選択肢を提供しました.
科学分野:
- 心臓病学 心臓病学
- 電気生理学 電気生理学
- 医療機器 医療機器について
背景:
- 4人の患者 (57~77歳,3人の男性) は,心筋梗塞後の薬剤耐性の心室性タキアリズムを患った.
- 静脈動脈不調は,右束枝ブロック形態 (RBBB) の単型静脈早拍 (VPBs) によって一貫して誘発された.
研究 の 目的:
- 急性心筋梗塞後の薬剤耐性の心室性タキアリズム症の患者でVPBを誘発するための放射性周波数 (RF) アブレーションの可行性と有効性を調査する.
主な方法:
- アクティベーションとペースのマッピングを含む左心室 (LV) のマッピングは,VPBsを誘発する起源を特定するために行われました.
- ラジオ周波数 (RF) 剥離は,VPBに先立つ最も初期の活性化部位とプーキンジェポテンシャルを標的とした.
主要な成果:
- VPBsの初期活性化は,アンテロメディアルまたはインフォロメディアルLVに局限していた.
- 短い,高周波,低振幅のポテンシャルがVPBより126-160ms前に記録され,また,PurkinjeポテンシャルがQRSより23-26ms前に記録された.
- これらのポテンシャルのRFアブレーションは,すべての患者でVPBを抑制し,5カ月から33カ月までのフォローアップ期間で心室低心率または動の再発はありませんでした.
結論:
- 心筋梗塞に続く静心室性タキアリズム症候群は,VPBによって引き起こされる可能性があります.
- これらのVPBを誘発する無線周波数アブレーションは,薬剤耐性電気嵐を防ぐために実行可能で効果的な治療法です.
- VPBsを誘発するカテーテル切除は,電気嵐のポストMI患者の貴重な救済療法として機能します.
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