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高密度映射 AVNRT 除与扭曲的导电系统解剖学后ASD 设备关闭案例报告

Subhrajit Lahiri¹, Maya Baman¹, Robert M Huibonhoa¹

¹Division of Pediatric Cardiology, Department of Pediatrics, University of Illinois College of Medicine, 1 Illini Drive, Peoria, IL, 61605, USA.

Indian pacing and electrophysiology journal

|September 25, 2025

概括

心房隔膜缺陷 (ASD) 的透导管关闭可能导致心律失常,如AVNRT由于设备干扰. 高密度测绘对于诊断和治疗这些术后并发症至关重要,确保患者的安全和最佳结果.

科学领域:

心脏病学心脏病学
电力生理学电力生理学
儿科先天性心脏病儿科先天性心脏病

背景情况:

前庭隔膜缺陷 (ASD) 是一种常见的先天性心脏缺陷,通过导管闭合是首选的最小侵入性治疗方法.
透导管ASD关闭带有7-10%的术后心律失常的风险,如勃拉迪亚心律失常和太基亚心律失常.
心律失常可能是由于对心脏导电组织或设备诱导的回流回路的机械干扰造成的.

研究的目的:

报告一个儿科病人的病例,该病例在通过导管ASD关闭后发生了AV节点复入性心力衰竭 (AVNRT).
在此背景下,强调高密度电解剖绘图 (HD绘图) 在治疗术后心律失常的有用性.
强调跨导管ASD关闭后长期随访的重要性.

主要方法:

一个案例研究的8岁的女性经历心跳和头后ASD关闭.
电生理学研究和详细地图绘制以确定心律失常基质.
通过使用高密度电解剖绘图 (HD绘图) 成功缓慢途径切除.

主要成果:

该患者在用高尔心形装置关闭两个ASD后一个月发生了AV节点复入性心力衰竭 (AVNRT).
高清测绘显示,由于设备的接近,在AV节点附近出现了解剖学扭曲,这有助于重新进入电路.
通过HD映射成功地进行了缓慢通路切除,在没有设备或组织损伤的情况下解决了心动减速.

结论:

过导管ASD关闭可以使患者易患AVNRT等心律失常,这是由于对心脏解剖学的机械影响造成的.
高密度的电解剖学测绘对于精确定位和治疗ASD关闭后的复杂心律失常是必不可少的.
先进的绘图技术提高了程序安全性,减少了辐射暴露,并优化了儿科患者的治疗结果.

关键词:

在ASD中,它是ASD.在 AVNRT AVNRT 中.导电缺陷导电缺陷导电缺陷设备关闭设备关闭高密度映射绘制的高密度映射

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