複雜性先天心臟病術前術後心律不整之電生理學機轉：以同步電位及之體結構定位法研究(3/3)
Date Issued
2002
Date
2002
Author(s)
吳美環
DOI
902314B002188
Abstract
Background. Congenital heart disease may
be associated with conduction system
abnormalities that may lead to clinical
arrhythmias and significant morbidity.
Methods. Patients with congenital heart
disease who had clinical arrhythmias were
enrolled. Standard electrophysiological study
and mandatory interventions, including
radiofrequency ablation and pacemaker
implantation, were performed under propofol
anesthesia. Electroanatomical mapping were
used when standard electrophysiological
study failed to identify or eliminate
theclinical arrhythmias.
Results. From 1993 to 2001, a total of 33
out of 317 (10%) patients received standard
electrophysiological study for clinical
arrhythmias were found to be associated with
congenital heart disease. Carto system
(electroanatomical mapping) was required in
three patients, due to postoperative reentrant
atrial tachycardia in two and reentrant
ventricular tachycardia in one.
In preoperative evaluation, the right atrial
isomerism was closely associated with
supraventricular tachycardia that has been
characterized as AV nodal-to-AV nodal
tachycardia. In contrast, patients with left
atrial isomerism were highly possible to
develop sick sinus syndrome and AV
conduction disturbance. Patients with
corrected transposition of great arteries could
also be associated with atrial flutter, atrial
tachycardia or AV nodal reentrant
tachycardia. Postoperative cardiac patients
could develop reentrant tachycardia
attributed to accessory pathways or incisional
atrial or ventricular reentrant tachycardia.
The incisional reentrant tachycardia carried
high recurrence risks even using the CARTO system
Conclusion.
Patients with certain types of congenital
heart diseases, including heterotaxy
syndrome and corrected transposition of great
arteries tended to have clinical arrhythmias
during childhood and should be managed
before surgical intervention. Postoperative
incisional reentrant tachycardia carried high
recurrence rate even with CARTO system
assisted RF ablation.
Subjects
Congenital heart disease
tachycardia
bradycardia
electroanatomical mapping
Publisher
臺北市：國立臺灣大學醫學院小兒科
Type
report
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