特发性左后分支型室性心动过速一例报道并文献复习

Idiopathic Left Posterior Fascicular Ventricular Tachycardia: A Case Report and Literature Review

本文介绍一例反复发作室性心动过速的患者,既往体健,经心内电生理检查诊断为特发性左后分支型室性心动过速,回顾了既往文献报道中特发性左后分支型室性心动过速相关临床特点。总结并指出特发性左后分支型室性心动过速可能与左心室假腱索具有关联性,心电图特点为类RBBB型宽QRS波心动过速,其中额面电轴偏转、电张调整T波改变对鉴别这种类型的心动过速具有重要意义,急诊终止该类型心动过速可首选维拉帕米等抗心律失常药物,且射频消融术为根治该类型心动过速的首选方法。

The paper reported a case of patient with repeated attack of fascicular ventribular tachycardia. The patient had no medical history before and was diagnosed as idiopathic left posterior fascicular ventricular tachycardia through intracardiac electrophysiological examination. We made a review of the relevant clinical characteristics of idiopathic left posterior fascicular ventricular tachycardia from previously published literature. We made a conclusion that idiopathic left posterior fascicular ventricular tachycardia may have a correlation with ventricular false tendons. The feature of ECG was right bundle branch block（ RBBB） type wide QRS tachycardia. The deviation of electrical axis and the electrotonic modulation of T wave are of great significance to identify this type of tachycardia. Verapamil and other antiarrhythmic drugs are the first choice to stop this kind of tachycardia in emergent treatment,and radiofrequency ablation is the first choice to eradicate this type of tachycardia.