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4)頻拍症の診断と治療効果判定(シンポジウム 不整脈をめぐる諸問題, 第475回新潟医学会)

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  • The Diagnosis and Managenent of Tachycardias(Current Topics on Cardiac Arrhythmias)

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In patients with WPW syndrome, atrial fibrillation with cosecutive preexcited RR interval less than 250 msec is predisposed to ventricular fibrillation. Atrioventricular reciprocating tachycardia via the bypass tract is confirmed by the eccentric retrograde atrial activation during tachycardia, and the ability to preexcite the atrium by ventricular stimulation at a time when His bundle is refractory. Sustained ventricular tachycardias are life threatening tachyarrhythmias, and electrophysiologic study-guided therapy is essential in the management of them. However, many sustained ventricular tachycardias are refractory to pharmacological therapy, and nonpharmacological therapy such as catheter ablation or surgery should be considered in drug resistant cases.

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