PERMANENT JUNCTIONAL RECIPROCATING TACHYCARDIA (PJRT) AND DILATED CARDIOMYOPATHY
Autori:
Ivan Malčić, Bruno Buljević, Wilhelm Kaltenbrunner,Dražen Jelašić, Željka Mustapić
Sažetak
Sažetak. Prikazujemo 14-godišnju djevojčicu s trajnom spojnom kružnom tahikardijom koja je bila refrakterna na konzervativnu terapiju. Uz to je bila prisutna i dilatacijska kardiomiopatija. Kod djevojčice je uspješno učinjena radiofrekventna ablacija akcesornog puta nakon čega je došlo do histoloških promjena u miokardu u smislu kompenzatorne hipertrofije srčane muskulature (»cardiac remodelling«). Nametnulo se pitanje uzroka i posljedice: je li postojeća tahikardija posljedica dilatacijske kardiomiopatije ili je posrijedi aritmogena kardiomiopatija. O toj dilemi raspravlja se u članku. Na osnovi učinje¬ne obrade i potpunog oporavka miokarda nakon ablacije akcesornog puta razvidno je da je posrijedi bila tahikardiomiopatija, tj. kardiomiopatija uzrokovana trajnom spojnom kružnom tahikardijom.
Summary
Summary. We present 14-year-old girl with permanent junctional reciprocating tachycardia which was refractory to medicamentous therapy, who also had dilated cardiomyopathy. She underwent successful radiofrequent catheter ablation of accessory pathway after wich the histologic changes in the myocardium were observed in the form of compensatory hypertrophy of cardiac muscle (cardiac remodelling). The question of cause and consequence appeared: whether the arrhythmia is a consequence of dilated cardiomyopathy, or it is tachycardia- induced cardiomyopathy. This particular issue is discussed in this article. Based on the diagnostic procedure and complete recovery of myocardium after catheter ablation of accessory pathway, it is obvious that the tachycardia was due to tachicardiomyopathy, i.e. cardiomyopathy caused by permanent reciprocating junctional tachycardia.
