右心室流出道憩室起源的室性心动过速继发室性早搏1例

A case of ventricular premature/ventricular tachycardia originating from right ventricular outfl ow tract diverticulum

右心室流出道憩室内起源的室性心律失常在国内外少有报道。本病例报道1例中老年男性患者,急性起病,表现为“无休止持续性室性心动过速”入院,术中标测时发现右心室流出道存在一异常畸形的解剖结构。根据阻抗值变化,并结合术中造影,考虑右心室流出道憩室,再通过多种标测方法,证实为憩室内起源的室性心动过速,经谨慎选择消融方式后,达到即刻成功,无手术并发症发生。随访无室性早搏或室性心动过速再发。通过本病例,笔者认为心律失常介入的每一环节,需细微缜密的观察、分析,方可对临床病例的实施起到积极的指导意义。

Cases of ventricular arrhythmias originating from the diverticulum of the right ventricular outflow tract are rarely reported domestically and internationally.We report a middle-aged and elderly male patient who was admitted to the hospital with an acute onset of"endless persistent ventricular tachycardia".During the surgery,an abnormal anatomical structure was found in the right ventricular outfl ow tract,and based on changes in impedance values and combined with intraoperative imaging,the right fl ow"diverticulum"was considered.Multiple mapping methods were used to confi rm the origin of ventricular tachycardia within the"diverticulum".After careful selection of ablation methods,immediate success was achieved,No surgical complications occurred;After follow-up,there was no recurrence of ventricular premature beats or ventricular tachycardia.Through this case,the author believes that every step of arrhythmia intervention requires meticulous observation and analysis in order to provide positive guidance for the implementation of clinical cases.