带有Mahaim纤维特征的左心室外辅助通路:一个罕见的病例报告
Jingjing Han1, Ruowen Yuan1, Jiazheng Li1
1Department of Cardiology, Lanzhou University Second Hospital, Lanzhou, 730030, China.
BMC cardiovascular disorders
|February 15, 2025
概括
抗发性心房回流性心力衰竭 (AVRT),经常被误诊为心室心力衰竭 (VT),可能难以检测. 这一案例突显了AVRT的成功诊断和治疗,使用大海姆纤维使用导管切除.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 抗性心房回流性心力衰竭 (AVRT) 呈现为宽QRS心力衰竭,经常被误诊为心室心力衰竭 (VT).
- 由于辅助通路 (AP) 速度较慢,表面ECG上的微妙或不存在的预激发使AVRT诊断复杂化.
- 错误诊断可能导致不适当的治疗和延迟对潜在疾病的管理.
研究的目的:
- 报告一个13岁男孩被误诊患有静脉瘤的病例,后者被证实患有抗瘤AVRT.
- 为了说明AVRT的诊断挑战和成功管理,使用Mahaim光纤辅助路径.
- 突出心内电生理学研究和导管切除在处理此类病例中的有用性.
主要方法:
- 内心电生理学研究以确定辅助途径.
- 在高心率发作之前,期间和之后,分析表面心电图.
- 检测到的辅助通路的导管无线电频率移除.
主要成果:
- 一名最初被诊断为VT的13岁男性被发现在左前自由壁上有一个AV辅助通路,在左前自由壁上有Mahaim纤维特征.
- 宽QRS低心率被证实为抗体动脉动脉逆转录疗法.
- 导管射频除成功消除了心动节拍,在6个月的随访中没有复发.
- 切除前和切除后心电图的比较揭示了隐藏的心室前兴奋波.
结论:
- 带有Mahaim纤维的抗瘤AVRT可以呈现为宽QRS心动减速,并被误诊为静脉动脉.
- 心内电生理学和向性切除在诊断和治疗这种疾病方面是有效的.
- 早期和准确的诊断对于适当的管理和预防并发症至关重要.
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