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[AHA2011]心房颤动治疗研究进展——Thomas Dewland教授专访
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作者:ThomasDewland 编辑:国际循环网 时间:2011/11/14 14:59:29 关键字:ICD  CRT 可穿戴式体外除颤器 WCD Thomas Dewland 


     <International Circulation>: You apparently had a case where a VT storm was terminated by a intracoronary injection.  The editors at International Circulation are very interested to hear more about this and the details of the episode.

   《国际循环》:您似乎有一个病例是关于心内注射引起了VT storm的终止。作为国际循环的编辑们,我们对于这个病例和其具体细节非常感兴趣。
 
    Prof. Thomas Dewland:It was a very sick patient who had a lot of coronary artery disease who came into the hospital with intractable VT and, despite all other pharmacologic interventions we could provide, he continued to remain in this rhythm.   It wasn’t until the patient was taken to angiography and received an injection into the right coronary artery that causes this rhythm to break.  It was subsequently found that he had quite a severe disease in the right coronary distribution.  Whether it was us that dislodged some plaque or caused changes in autonomic tone that brought about the change in rhythm is unclear.  After stenting the patient he remains VT rhythm-free.  After about one year I saw the patient and, despite his advanced age and multiple other medical co-morbidities, he seemed to be doing pretty well.  

    Dewland教授:这个患者的病情非常严重,在入院时存在多种冠状动脉疾病和顽固性的VT,尽管我们对其进行了各种药物性干预,他的心脏节律仍没有改变。直到患者被送到血管造影中心接受了右冠状动脉注射后,才使患者的心律失常停止了·。后来发现该患者的右冠状动脉分支存在非常严重的疾病。究竟是不是我们去除了斑块或是改变了自主神经张力引起了心律的变化均不清楚。在支架植入术后,患者的VT节律仍然正常。大约一年以后,我见到了这位患者,尽管他年事已高并存在多种其他医学并发症,他的状况似乎非常好。
 
    <International Circulation>:  So pulling him out of that rhythm seemed to put him back on track then?

   《国际循环》:这样看来,纠正他的心律失常似乎使其回归了正轨?
 
    Prof. Thomas Dewland: Once we revascularized that region of the myocardium and whether recurrent ischemia was causing some issues with intercellular conduction or some other predisposition to ventricular arrhythmias is unclear.  We have all be postulating how revascularization in this setting resulted in nearly full resolution of his arrhythmic symptoms.   

    Dewland教授:当我们使那部分心肌恢复了血液供应后,究竟是反复发作的心肌缺血导致了细胞间传导的问题,或是其他室性心律失常引起的问题就不清楚了。我们姑且在此假定,血运重建在这种情况下几乎全部解决了患者心律失常的症状。
 



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