@article{oai:nagasaki-u.repo.nii.ac.jp:00017669,
 author = {泉, 賢太 and 江石, 清行 and 橋詰, 浩二 and 多田, 誠一 and 山根, 健太郎 and 高井, 秀明 and 谷川, 和好 and 三浦, 崇 and 中路, 俊},
 issue = {4},
 journal = {日本心臓血管外科学会雑誌, Japanese Journal of Cardiovascular Surgery},
 month = {Jul},
 note = {症例は 63歳,男性.20年前より肥大型心筋症(HCM)として加療されていた.2年前より,抗不整脈薬投与にもかかわらず心室頻拍(VT)をくり返し,ICD(implantable cardioverter defibrillator)植込み術を施行した.また,拡張相肥大型心筋症の病態を呈していた.その後もVTをくり返しICDが頻回に作動した.薬剤抵抗性であり,アブレーションを行うため,EPS(electrophysiological study)を施行した.CARTO system(electroanatomical mapping system)によるactivation mapでは,VTは左室後側壁の一部を最早期興奮部位として周囲に広がった.心内膜下から計2回のアブレーションでもVTは停止せず,起源は心外膜側のリエントリーと考えられ,左室後側壁部分切除術を施行した.術後,VTの出現はなくなった.心外膜側起源と考えられた拡張相肥大型心筋症による薬剤抵抗性の VTに心筋切除が著効した症例を経験したので報告する., A 63-year-old man had been receiving medical treatment for hypertrophic cardiomyopathy (HCM) for 20 years. Sustained ventricular tachycardia (VT) had often occurred over the previous 2 years in spite of the administration of antiarrhythmic drugs. He therefore received an implantable cardioverter defibrillator (ICD). However, his symptoms did not improve thus dilated-phase HCM was diagnosed. Because sustained VT often occurred subsequently, the ICD had to be frequently used. An electrophysiological study (EPS) using the CARTO electroanatomical mapping system revealed the earliest activation site to be in the posterolateral wall of the left ventricle (LV). VT did not stop despite 2 endocardial catheter ablation procedures. Therefore, the VT foci was thought to be a reentry circuit on the epicardial side of the posterolateral LV wall. A part of the posterolateral LV wall that involved the reentry circuit was therefore resected. Since undergoing this surgical procedure, the patient has experienced no recurrence of VT during a follow-up period of 14 months., 日本心臓血管外科学会雑誌, 36(4), pp. 184-187; 2007},
 pages = {184--187},
 title = {拡張相肥大型心筋症による難治性心室頻拍に対し心筋切除術が著効した1例},
 volume = {36},
 year = {2007}
}