通过马歇尔静脉介导的心房的乙醇输液
Xiaohua Zhao1, Fuding Guo1, Sen Yang1
1Key Laboratory of Cardiovascular Disease of Yunnan Province, Clinical Medicine Center for Cardiovascular Disease of Yunnan Province, Department of Cardiology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, China.
JACC. Case reports
|January 14, 2026
概括
在心房动 (AF) 移除后,反复出现的非典型心房动 (AFL) 可能涉及马歇尔静脉 (VOM). 乙醇输入VOM有效地治疗了这种具有挑战性的疾病,恢复了鼻节律.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医学案例报告 病例报告
背景情况:
- 在心房动 (AF) 移除后的非典型心房 (AFL) 是一个重大的治疗挑战.
- 副心脏结构,特别是马歇尔静脉 (VOM),可以调解切除后的AFL.
- 识别和治疗这些上心脏基质对于患者管理至关重要.
研究的目的:
- 报告一个由马歇尔静脉介导的AF切除后复发的AFL病例.
- 评估将乙醇输入VOM的疗效,以治疗VOM介导的AFL.
- 突出全面地图的重要性,以识别AFL的表心基质.
主要方法:
- 使用高密度和引力映射来描述回入电路的特征.
- 试图进行内心切除,但没有成功.
- 乙醇输入VOM作为一个有针对性的治疗干预.
主要成果:
- 通过表心导电确定了一个涉及VOM的宏回入电路.
- 在VOM中注入乙醇后,AFL立即终止.
- 在1年的随访中,患者保持了鼻节律,左心室喷射率 (46%至68%) 显著改善.
结论:
- 综合的电生理学测绘对于诊断AFL后AF除是必不可少的,特别是当怀疑是表心基质时.
- 马歇尔介导的静脉AFL可以通过向的乙醇输液有效和安全地治疗.
- 这种方法提供了一个有前途的治疗策略,用于绝缘后AFL的耐火病例.
相关概念视频
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
464
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
464
Venous Thrombosis III: Interprofessional Care
278
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
278
Varicose Veins II: Diagnostic Studies and Interprofessional Care
183
Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...
183
Dysrhythmias VI: Management of Dysrhythmias
428
Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
428
Disturbances in Heart Rhythm
2.5K
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
2.5K
Mitral Regurgitation III: Medical Management
274
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
274


