Alaa A Shalaby, Bassem S Hendawy, Daniel G Wann, Aditya Bhonsale, Krishna Kancharla, Andrew Voigt, Sandeep Jain, Mark Estes, Samir Saba, Konstantinos N Aronis
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引用次数: 0
Abstract
Background: Bipolar radiofrequency ablation has been increasingly used in cases with deep intramyocardial circuits refractory to unipolar ablation. Patients with Lamin A/C cardiomyopathy frequently exhibit VT arrhythmia originating from deep in the interventricular septum.
Methods and results: We describe our use of bipolar ablation in a patient with nonischemic cardiomyopathy and Lamin A/C mutation for the treatment of a septal VT substrate with particular attention to pathology findings at 3 months.
Conclusions: Bipolar ablation with catheters across the septum and in the presence of a microcatheter in a septal branch of the anterior interventricular vein was effective in controlling ventricular arrhythmia. Resultant ablation resulted in extensive myocardial injury and fibrosis. Neointimal hyperplasia of intervening coronary arteries may play a role in subsequent effects of initial ablation lesions.
背景:双极射频消融术越来越多地应用于单极消融术治疗难治性心内深部回路的病例。纤层蛋白A/C型心肌病患者常表现为室间隔深部的室间性心律失常。方法和结果:我们描述了我们对患有非缺血性心肌病和Lamin a /C突变的患者使用双极消融术治疗室间隔VT底物,并特别注意3个月的病理结果。结论:双极消融术通过导管穿过室间隔,并在室间隔前静脉分支置入微导管,可有效控制室性心律失常。由此引起的消融导致广泛的心肌损伤和纤维化。介入冠状动脉内膜增生可能在初始消融病变的后续影响中起作用。
期刊介绍:
Journal of Cardiovascular Electrophysiology (JCE) keeps its readership well informed of the latest developments in the study and management of arrhythmic disorders. Edited by Bradley P. Knight, M.D., and a distinguished international editorial board, JCE is the leading journal devoted to the study of the electrophysiology of the heart.