左室不充盈和房间隔缺损患者选择抗心律失常疗法的困难:病例报告

M. Skhirtladze, E. A. Losik, E. Bueverova, A. S. Cherenda
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引用次数: 0

摘要

简介左心室不充盈(LVNC)是一种罕见的异质性病变,其特征为两层结构,非充盈层占主导地位,表现为多个小梁和小梁之间的凹陷,与左心室腔相通。罕见的 LVNC 表型之一是合并先天性心脏缺陷,包括房间隔缺损(ASD)。文章介绍了一个病例报告,描述了一名 LVNC 和 ASD 患者在选择抗心律失常治疗时遇到的困难,该患者因心力衰竭并发心律失常。讨论。LVNC和先天性心脏缺损患者的心律失常是心脏电不稳定性的解剖和血液动力学原因造成的,构成血栓栓塞和心脏性猝死的危险,也会导致心力衰竭恶化。该病例之所以引人关注,是因为它罕见地合并了 LVNC 和 ASD,并伴有频繁发作的心房颤动和以副阵搏形式出现的室性早搏,而且在选择抗心律失常治疗时也存在困难。肺静脉冷冻球囊消融术消除了心房颤动的源头。使用抗惊厥药物卡马西平阻止了室性异位活动。
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Difficulties in selecting antiarrhythmic therapy in a patient with left ventricular noncompaction and atrial septal defect: a case report
Introduction. Left ventricular noncompaction (LVNC) is a rare heterogeneous pathology characterized by a two-layered structure with a predominance of non-compact layer in the form of multiple trabeculations and pockets between them, communicating with the left ventricular cavity. One of the rare LVNC phenotypes is a combination with congenital heart defects, including atrial septal defect (ASD).Brief description. The article presents a case report describing the difficulties of selecting antiarrhythmic therapy in a patient with LVNC and ASD, complicated by arrhythmias due to heart failure. The diagnosis of LVNC was confirmed by the Petersen criterion using magnetic resonance imaging.Discussion. Cardiac arrhythmias in patients with LVNC and congenital heart defects, as a result of both anatomical and hemodynamic causes of electrical heart instability, constitute a danger of thromboembolism and sudden cardiac death, and also contribute to heart failure progression. The case is of interest due to the rare combination of LVNC and ASD, complicated by frequent episodes atrial fibrillation and premature ventricular contractions in the form of parasystoles, as well as difficulties in selecting antiarrhythmic therapy. Pulmonary vein cryoballoon ablation eliminated the source of atrial fibrillation. Ventricular ectopic activity was stopped using the anticonvulsant drug carbamazepine.
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来源期刊
Cardiovascular Therapy and Prevention
Cardiovascular Therapy and Prevention Medicine-Cardiology and Cardiovascular Medicine
CiteScore
1.70
自引率
0.00%
发文量
155
审稿时长
6-12 weeks
期刊介绍: The most important objectives of the journal are: the generalization of scientific and practical achievements in the field of cardiology, increasing scientific and practical skills of cardiologists. The scientific concept of publication does the publication of modern achievements in the field of epidemiology, prevention and treatment of cardiovascular diseases, the results of research, national and international clinical trials. For publication in the journal are invited both domestic and foreign scientists and clinicians working in the field of cardiology, as well as doctors of other specialties. The magazine covers various issues in cardiology and related specialties. Each issue is prepared by Executive editor of the issue, a respected specialist in the field of epidemiology, prevention and treatment of cardiovascular diseases. The main focus of the publication — scientific articles on original research, the pharmacotherapy of cardiovascular disease, new diagnostic methods. All members of the group of authors should meet all four criteria of authorship set forth in the ICMJE recommendations: 1) concept and design development or data analysis and interpretation, and 2) manuscript justification or verification of critical intellectual content, and 3) final approval for publication of the manuscript, and 4) consent to be responsible for all aspects of the work, and assume that issues relating to the thoroughness and diligent execution of any part of the study submitted are duly investigated and resolved. Great importance the editors attached to the preparation of scientific papers by groups of authors at a high level, literacy, authors, and their ownership information, availability of research results not only to colleagues in Russia, but also abroad.
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