A case with inferior vena cava filter of right accessory pathway ablation through superior vena cava approach
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摘要: 患者因反复胸闷胸痛7年、心悸2 h入院。临床诊断为阵发性室上性心动过速(PSVT)。患者于20年前植入下腔静脉滤器。电生理检查明确诊断为右侧隐匿性旁道介导的房室折返性心动过速(顺向性)。后通过上腔静脉入路成功消融。对于难以通过下腔静脉入路消融的患者来说，上腔静脉入路可能是一种安全、有效和可行的方法。Abstract: A patient was admitted to the hospital with a history of repeated chest tightness and pain for 7 years, accompanied by palpitations lasting 2 hours. Clinical diagnosis revealed paroxysmal supraventricular tachycardia (PSVT). The patient had an inferior vena cava filter implanted 20 years ago. A clear diagnosis was established through electrophysiological examination, indicating right concealed accessory pathway-mediated atrioventricular reentrant tachycardia (anterograde). Successful ablation was performed through the superior vena cava approach. Therefore, the superior vena cava approach may be considered a safe, effective, and feasible method for patients who are challenging to ablate via the inferior vena cava approach.
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图 1 患者ECG、腹部立位片、腔内电图及消融靶点图
Figure 1. Patient's ECG, abdominal orthostatic film, intracavitary electrogram, and ablation target map
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