A case of two types AV nodal reentrant tachycardia associated with idiopathic left ventricular tachycardia

DOI
  • Takano Makoto
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Harada Tomoo
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Takagi Yasushi
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Yamada Marika
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Nakano Emi
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Takimura Yukako
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Matsuda Hisao
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Nishio Satoru
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Furukawa Toshiyuki
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Miyazaki Hidekazu
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Matsumoto Naoki
    Pharmacology, St. Marianna University School of Medicine
  • J Akashi Yoshihiro
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine

Bibliographic Information

Other Title
  • ベラパミル感受性心室頻拍に2種類の房室結節回帰性頻拍を合併した1例

Search this article

Description

<p> 症例は, 18歳男性. 主訴は動悸. 中学生時代から運動中の動悸を自覚, 今回精査目的に来院. 外来での運動負荷試験で右脚ブロック型/左軸偏位 (RBBB/LAD) の心室頻拍 (VT) が誘発され, ベラパミルで停止した. そのためVTに対して心臓電気生理学的検査 (EPS) およびカテーテルアブレーション (CA) 目的に入院となる. EPSでは, RBBB/LAD型のVTが誘発され, 左脚後枝領域のPurkinje電位を認める部位でCAを施行し, VTは停止した. CA後, VTの誘発を試みるためイソプロテレノール投与下での心室期外刺激でVTは誘発されず, narrow QRS tachycardia (long RP`type) が誘発された. また心房期外刺激では, 別のnarrow QRS tachycardia (short RP`type) が誘発された. それぞれは, fast-slow型房室結節回帰性頻拍 (AVNRT) とslow-fast型AVNRTと診断した. そのためslow pathwayのCAを行うためにカテーテルでHis束を同定している際に一過性の房室ブロックとなり, CAは断念した. 今回我々は, ベラパミル感受性左室特発性心室頻拍に対して左脚後枝領域通電後, 2種類のAVNRTが誘発され, slow pathwayの焼灼前に一過性房室ブロックとなった若年症例を経験したので, 報告する.</p>

Journal

  • Shinzo

    Shinzo 47 (SUPPL.2), S2_120-S2_123, 2015

    Japan Heart Foundation

Keywords

Details 詳細情報について

Report a problem

Back to top