DC 欄位 | 值 | 語言 |
dc.contributor.author | 吳美環 | zh_TW |
dc.creator | 吳美環 | zh_TW |
dc.date | 2002 | zh_TW |
dc.date.accessioned | 2006-07-26T03:07:45Z | - |
dc.date.accessioned | 2018-07-11T17:50:08Z | - |
dc.date.available | 2006-07-26T03:07:45Z | - |
dc.date.available | 2018-07-11T17:50:08Z | - |
dc.date.issued | 2002 | - |
dc.identifier | 902314B002188 | zh_TW |
dc.identifier.uri | http://ntur.lib.ntu.edu.tw//handle/246246/22875 | - |
dc.description.abstract | 先天心臟病病兒常合併心傳導系統異
常。這些傳導異常性質可能導致臨床不整
脈,進而影響其預後。此外,經開心手術
成功矯治後的先天性心臟病兒,由於手術
瘢痕等問題易有心房或心室繞行性頻脈,
藥物治療相當困難。
本研究探討先天性心臟病術前術後之
心律不整,(1)其型態以其特殊之機轉(2)
以傳統心電生理檢查方法及電燒灼術治療
之可行性,以及(3)以Electroanatomical
mapping (CARTO system)輔助之不整脈
定位及燒灼術之適應性。由1993 年到2001
年,共33 位接受心電生理檢查病兒(占所
有病兒10%)合併有先天性心臟病。有三
位病兒之頻脈必須採用CARTO system 輔
助之定位與燒灼(二例心房繞行頻脈,一
例心室繞行頻脈)。在術前之病兒,兩側
右心房症病兒有相當高的概率合併一種相
當特殊的心頻脈, 我們稱之為AV
nodal-to-AV nodal tadycardia。反之,兩側
左心房症病兒易有竇房結及房室結功能不
良。此外,先天矯正型大血管轉位病也有
常有上心室頻脈。這些術前心律不整大多
可以傳統之電生理檢查方法與電燒灼術等
予以根治,然而先天性心臟病兒術後之頻
脈若與開刀瘢痕有關,則復發率高,且常
須輔以須輔以CARTO system。但即使如
此,復發率仍偏高。
CARTO system 由於尺寸較大,不適用
於較小兒童,且其導管價格極為昂貴。因
此,較適用於開心手術後繞行性頻脈之定
位與燒灼。 | zh_TW |
dc.description.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. | en |
dc.format | application/pdf | zh_TW |
dc.format.extent | 121756 bytes | - |
dc.format.mimetype | application/pdf | - |
dc.language | zh-TW | zh_TW |
dc.language.iso | zh_TW | - |
dc.publisher | 臺北市:國立臺灣大學醫學院小兒科 | zh_TW |
dc.rights | 國立臺灣大學醫學院小兒科 | zh_TW |
dc.subject | 先天性心臟病 | zh_TW |
dc.subject | 心律不整 | zh_TW |
dc.subject | Congenital heart disease | en |
dc.subject | tachycardia | en |
dc.subject | bradycardia | en |
dc.subject | electroanatomical mapping | en |
dc.title | 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) | zh_TW |
dc.type | report | en |
dc.identifier.uri.fulltext | http://ntur.lib.ntu.edu.tw/bitstream/246246/22875/1/902314B002188.pdf | - |
dc.coverage | 計畫年度:90;起迄日期:2001-08-01/2002-07-31 | zh_TW |
item.openairecristype | http://purl.org/coar/resource_type/c_93fc | - |
item.openairetype | report | - |
item.languageiso639-1 | zh_TW | - |
item.grantfulltext | open | - |
item.cerifentitytype | Publications | - |
item.fulltext | with fulltext | - |
顯示於: | 醫學系
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