A Young Case of IntraFascicular Ventricular Tachycardia with Narrow QRS Complex
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概要
- 論文の詳細を見る
<B>Introduction:</B> Some previous reports demonstrated that ventricular tachycardia may rarely show narrow QRS complex. We experienced a young boy who had past history of Kawasaki disease with such a pattern of ventricular tachycardia. <B>Case Presentation:</B> A 14 year-old boy was transferred to our emergency department in a hemodynamically collapsed state. On 12-lead electrocardiograms, narrow QRS tachycardia with left posterior hemiblock morphology was recorded. We tried to terminate the tachycardia by intravenous infusion of medicine. At first, ATP was injected rapidly, the tachycardia was not terminated. We subsequently injected procainamide. The tachycardia was terminated. QRS complexes during sinus rhythm were similar to those during the tachycardia. Imaging examinations did not reveal structural heart disease on him. We performed electrophysiological study for diagnosis of the tachycardia. The tachycardia was easily induced by atrial extra stimulus and terminated by atrial burst pacing. The interval of His-right fascicular potentials was shorter than that of normal sinus rhythm. Therefore, the mechanism of the tachycardia was assumed to be microreentry rotating around proximal site of purkinje network, which means intrafascicular ventricular tachycardia. In other day, we tried catheter ablation, but the tachycardia was no more induced by any stimuli, so we could not have the procedure. The young patient was treated with oral administration of procainamide and remained asymptomatic.
著者
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Ikeda Takanori
Department Of Cardiovascular Medicine Graduate School Of Medicine Kyoto University
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Fujino Tadashi
Department Of Cardiovascular Medicine Toho University Omori Medical Center
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Yuzawa Hitomi
Department Of Cardiovascular Medicine Toho University Omori Medical Center
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Fukunaga Shunji
Department of Cardiology, Kawasaki social insuarance hospital
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Yamazaki Junichi
Department Of Biofunctional Science Faculty Of Agriculture And Life Science Hirosaki University
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Sato Hideyuki
Department Of Applied Chemistry Faculty Of Science And Technology Keio University
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Okano Yoshifumi
Department Of Cardiology Toho University Omori Medical Center
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Kobayashi Kenzaburo
Department of Cardiovascular Medicine, Toho University Medical Center
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Kobayashi Kenzaburo
Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan
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