個案報告：以房室結電燒同時治療心室再同步治療去顫器病人之心房撲動併心室心率過速與不適當電擊引發之心室頻脈

Successful treatment of Both Atrial Flutter with Rapid Ventricular Response and Inappropriate Shock-Induced Ventricular Tachycardia by Atrioventricular Node Ablation in a Patient with a Cardiac Resynchronization Therapy-Defibrillator

我們報告一位具有植入性心臟再同步治療去顫器的心臟衰竭患者，因寬QRS波頻脈而被除顫器的重複電擊。我們發現寬QRS波頻脈事實上是以一比一傳導至心室的心房撲動，卻因而引發去顫器不適當的電擊，不適當的電擊更誘發了數次的心室頻脈。我們進行了房室結燒灼術，成功消除了不適當的電擊並改善了雙心室同步節律。

 

We report a patient with heart failure who received a cardiac resynchronization therapy defibrillator implant and suffered from wide QRS complex tachycardia and repetitive shocks from his defibrillator. Several episodes of ventricular tachycardia were induced by inappropriate defibrillator shocks for slow atrial flutters with one to one ventricular conduction. We performed atrioventricular node ablation and successfully eliminated the inappropriate shocks and improved biventricular capture.