医博园 - 【翻译】心脏移植术后的心房并行收缩（新英格兰医学杂志系列036）

Posted by: 约瑟福
Posted on: 2008-08-03 16:50

Atrial Parasystole after Heart Transplantation

Three years after undergoing heart transplantation, a 44-year-old man presented with very frequent supraventricular extrasystoles (asterisks). Myocardial rejection and clinically significant hemodynamic alterations were excluded as causes. During an electrophysiologic study, an electrode was positioned in the right atrium of the donor heart and in the native right atrial remnant. As expected, the native atrium was beating independently of the donor atrium. However, the beats from the native atrium elicited a premature atrial depolarization in the donor heart whenever they occurred more than 190 msec after the last atrial depolarization (arrows). Apparent conduction of the cardiac impulse across the recipient?Cdonor atrial suture line is an uncommon cause of arrhythmias after heart transplantation, and its mechanism is unknown. In this case it resulted in atrial parasystole. Changing the rate of pacing of the native atrium had no effect on this phenomenon. During follow-up, the extrasystoles persisted. Since the arrhythmia was well tolerated by the patient, no therapy was initiated.

【翻译】心脏移植术后的心房并行收缩（新英格兰医学杂志系列036）
	Print