ナカニシ トシオ   NAKANISHI Toshio
  中西 敏雄
   所属   医学部 医学科(東京女子医科大学病院)
   職種   特任教授
論文種別 症例報告
言語種別 英語
査読の有無 査読あり
表題 Successful catheter ablation of ventricular tachycardia in a patient with congenitally corrected transposition of great arteries after double switch operation.
掲載誌名 正式名:SpringerPlus
略  称:Springerplus
ISSNコード:21931801
掲載区分国外
出版社 Springer
巻・号・頁 5,pp.341
著者・共著者 TOYOHARA Keiko†, NISHIMURA Tomomi, NAKANISHI Toshio, SHODA Morio
発行年月 2016
概要 Ventricular tachycardia (VT) may cause sudden death late after repair of congenital heart disease. Radiofrequency catheter ablation (CA) of VT can be effective but may be hampered by hypertrophied myocardium or prosthetic material. A 33-year-old man with congenitally corrected transposition of the great arteries (ccTGA) had undergone a double switch operation (DSO) with the combined Mustard and Rastelli procedures when he was 10 years old. He developed sustained VT 16 years after the surgery. An electrophysiological study was performed using a 3D mapping system. During the VT, abnormal fragmented potentials were identified in the right ventricular side near the patch of ventricular septal defect. Radiofrequency energy was delivered at the site with changes in the QRS morphology. Electroanatomical mapping of the left ventricle was performed via a retrograde transaortic approach. Successful ablation of the fractionated potentials was likewise achieved on the left side. We report, to our knowledge, the first case of a successful radiofrequency CA of VT in a patient with ccTGA after a DSO. A slow conduction zone, which was proved to be part of the tachycardia substrate, existed around the patch of ventricular septal defect. Fragmented activities during VT were recorded from both ventricles. The tachycardia circuit was eliminated after ablating the right and left sides of the ventricular septal defect patch.
DOI 10.1186/s40064-016-1903-4
PMID 27066360