PDF(Pubmed)
Abstract：
A 63-year-old man with hypertrophic cardiomyopathy (HCM), mid-ventricular obstruction, and an apical aneurysm had an episode of cardiac arrest due to sustained ventricular tachycardia (VT). He was resuscitated and an implantable cardioverter-defibrillator (ICD) was implanted. In the following years, several episodes of VT and ventricular fibrillation were successfully terminated by antitachycardia pacing or ICD shocks. Three years after ICD implantation, he was re-admitted because of refractory electrical storm (ES). Since aggressive pharmacological treatments, direct current cardioversions, and deep sedation were not effective, he underwent epicardial catheter ablation which was successful to terminate ES. However, because of the recurrence of refractory ES after one year, he proceeded to surgical left ventricular myectomy with apical aneurysmectomy which provided him a relatively stable clinical course for six years. Although epicardial catheter ablation may be an acceptable option, surgical resection of apical aneurysm seems to be most efficacious for ES in patients with HCM and an apical aneurysm.
UNASSIGNED: In patients with hypertrophic cardiomyopathy (HCM), implantable cardioverter-defibrillators (ICDs) are the gold standard of therapy for prophylaxis against sudden death. Electrical storm (ES) caused by recurrent episodes of ventricular tachycardia can cause sudden death even in patients with ICDs. Although epicardial catheter ablation may be an acceptable option, surgical resection of apical aneurysm is most efficacious for ES in patients with HCM, mid-ventricular obstruction, and an apical aneurysm.
UNASSIGNED: In patients with hypertrophic cardiomyopathy (HCM), implantable cardioverter-defibrillators (ICDs) are the gold standard of therapy for prophylaxis against sudden death. Electrical storm (ES) caused by recurrent episodes of ventricular tachycardia can cause sudden death even in patients with ICDs. Although epicardial catheter ablation may be an acceptable option, surgical resection of apical aneurysm is most efficacious for ES in patients with HCM, mid-ventricular obstruction, and an apical aneurysm.
摘要：
一名63岁的男性患有肥厚型心肌病（HCM），心室中段梗阻,根尖动脉瘤因持续性室性心动过速(VT)而出现心脏骤停.他被复苏，并植入了可植入的心脏复律除颤器（ICD）。在接下来的几年里,抗心动过速起搏或ICD电击成功终止了多次室性心动过速和室颤.ICD植入三年后，他因难耐电风暴（ES）而被重新录取。由于积极的药物治疗，直流电复律,深度镇静并不有效，他接受了心外膜导管消融,成功终止了ES.然而,由于难治性ES一年后复发，他进行了左心室心肌切除术和心尖动脉瘤切除术，这为他提供了六年相对稳定的临床过程。尽管心外膜导管消融可能是一种可接受的选择,对于患有HCM和根尖动脉瘤的ES患者，手术切除根尖动脉瘤似乎最有效。
■在肥厚型心肌病（HCM）患者中，植入式心律转复除颤器(ICD)是预防猝死的金标准.即使在ICD患者中，由室性心动过速反复发作引起的电风暴（ES）也会导致猝死。尽管心外膜导管消融可能是一种可接受的选择,对于患有HCM的ES患者，根尖动脉瘤的手术切除最有效，心室中段梗阻,和根尖动脉瘤.
■在肥厚型心肌病（HCM）患者中，植入式心律转复除颤器(ICD)是预防猝死的金标准.即使在ICD患者中，由室性心动过速反复发作引起的电风暴（ES）也会导致猝死。尽管心外膜导管消融可能是一种可接受的选择,对于患有HCM的ES患者，根尖动脉瘤的手术切除最有效，心室中段梗阻,和根尖动脉瘤.
