抄録第 13 回日本小児心電学研究会 PEDIATRIC CARDIOLOGY and CARDIAC SURGERY VOL. 25 NO. 5 ( ) VSD Brugada 1 Brugada Brugada = mm 5mm Qp/Q

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1 抄録第 13 回日本小児心電学研究会 PEDIATRIC CARDIOLOGY and CARDIAC SURGERY VOL. 25 NO. 5 ( ) VSDBrugada 1 Brugada Brugada = mm 5mm Qp/Qs = 4.20 LR shunt = 80Pp/Ps = 0.93 Pp/Ps = 0.60 Rp = kg V1 3 ST Tr J = 0.07 Brugada STr J = r J = 0.12 V1 2 ST coved Brugada V1 2 ST 21V1 2 coved ST pilsicainide 27 PIL 0.1mg/kg 4 ST r J Brugada 26 EPSRV pacing polymorphic VT VFBrugada ICD Brugada coved type ST Brugada CPVT 13 CPVT CPR AEDVF QT LQTSb LQTS2 LQTS1 MDCT high take off PVCQTc CPVT Ca CPVT ICD

2 733 3 CPVT PAT PVC Qp/Qs 3.3 SNRT 675ms poly-pvcs2 11 PAT poly-pvcs PAT poly-pvcs 1 2 CT poly-vt PVC poly-pvcs poly-vtwide QRS tachycardia VT 3 VTRR PAT PPCPVT PAT AED CPVT PMI EPSRVO VT HV 90msec2 10 VTPMI3 7 PM EPSAF VT 7 EPS VT 8 1 DC8 8 VT 30mg 1mg/kg PVTVT VT QRS QRS QRS 5 HERG 1 12 Holter 300bpm VT 11 5 X CTR HR 73bpm QT 0.40 QTc propranolol 60mg VT VT RFCA Isoproterenol isoproterenol

3 734 RFCA VPC propranolol 1 1 torsade de pointes TdP QTLQTS HERG exon 5 S320L C959T LQTS propranolol RFCAVPC VT 6 VT HERG VPC TdP 6 LQT1 1 LQT1 1 LQT1 1965kg LQT1 3 LQT 19 1 TWA T-wave alternans TdP torsade de pointes HR mg 20mgQTc 444ms 688ms TWA TdPHR mg QTc 597msTWAHR mg TWA TdP 120mg 120mg 1 1 LQT1 1 2 QT 7 AED QT AED kg cm CPA 119 AEDCPR 2 AED 5 JCS Japan Coma Scale /62 105bpm SpO GCS Glasgow Coma Scale E1V1M4 QT CPK torsades de pointes Mg 3 intact AED ICU 8 b

4 TCPS 40eg/kg/ min 90 10eg/kg/min I HR 180 JET 40eg/kg/min eg/kg/min AAI 3 6 DDD 8eg/kg/min DDI eg/kg/min 9 b 1 -blocker WPW 1 HR 250/min ATP 10c HR 260/min 250/min ATP 2 DORVWPW 5 cryoablation HR 275/min ATP 125c 1 40c 5mg/kg 3 TA 293 ASD creation EAT -blocker29 TCPC 1c EAT 4 C-TGA.PA.Rastelli 28TVR PSVT ATP 100c 1 5 PA.IVS. 24 HR 100/min 3 5c Fontan 4 TCPC 2 Williams JET 1 1 2mg/kg 20 30loading 0.5mg/kg/h mg

5 loading 1 1,000ng/ml ng/ml JET loading PVT Na mexiletine lidocaine procainamide disopyramide propafenone flecainide 1 PVT ATP Ca verapamilk nicorandil PVT 8 1 PVT PVT propranolol nadolol Ca verapamil K nicorandil EF EF ICD KCNJ2 926cytosine > thymine 12 Shock lead replacement for multiple inappro-apriate shocks in a child undergoing double switch operation 8 13 ICU 214/ VT70mmHg DCVT V-stim clinical VT ICD VT ICD ICD 7 Wii box game ICD VT HV oversensing Senning lead extraction back up sleeve ICD ICD AVR + MVR VDD Medtronic LEF10199V 58cm RV VDD mode bpm AV delay 150ms PMI 3 TMT Bruce 5 50stage II

6 bpm 60bpm PM sensing failure 2 1 AV A PMI DDD13 V AAI mode digoxin verapamil AF AT 2 AT PM DDD mode bpm AVD 250ms wide QRS tachycardia episodes HR bpm AT PSVT V pacingpacing mode ATCA 14 PMI 1990PMI VVI R 14 DDD R 18AAI 3 VVI R 8 DDD R PMI PMI TCPC PMI PMI 15 Mustard PMI PMI Mustard stenosis/svc S/S index 6 1 PMI SVC AAIR 2 2 VVI AAI Mustard 4 2 PMI 16 ICD 2 ICD

7 PCPS AED AEDICD EPS 3 Vf ICD159cm 55kgSt. Jude Medical SJM single coilrv IVC Generator Medtronic VIRTUOSO 36.5cc 68g 15mm T DCM ACE AED EPS 2 Vf DCICD140cm 37kg SJM single coilrv IVC Generator SJM ATLAS 37cc 77g 14mm ICD 1 2 single chamber VVI dual coilsingle coil 17 3 CRT CRT 3 CRT 1 CAVB + DCM 3 9.8kg SS-A 2 VVI RV pacing 2 DCM CRT TSI tissue synchronization imaging QRS Ao-VTIAV delay 100msec reverse remodeling 2 CAVB + DCM kg CAVB1 2 CAVB1 4 VVI, RV pacing 3 dp/dtddd AV delay 100msec VV delay 20msec LV CRT 3 CHD kg 1 2 CAVB DDD RA- RV pacing CRTAV delay 100msec VV delay 40msec LV RV pacing 2 CRT CRT 18 monoventricular pacing fusion CRT Fontan CRT indeterminate ventricle{a D L}Ib Glenn + 4 wide QRS 125ms 16 9mmHg Q-LAB

8 739 3DQ dyssynchronicity ACE 1 4 fusion CRT 1/3 lower 80bpm AV delay 80ms DDD fusion 97AsVp QRS 85ms 10 5mmHg TCPC mmHg 3.2 dp/dt = gross anatomy 3DQ 1 fusion 19 CRT 1 CRT CRT cm 9.4kg 1 1 DDD 1 BNP 634pg/ml LVIDD 38.6mm 138 ofn LVEF Simpson 21 dyssynchrony dyssynchrony LVEF70 32LVEDV of N CRT INSYNC III LV-RV delay AV delaytee A-V delay 120ms V-V delay 60ms LV fast RV delayed pacingrv pacing10mmhg dyssynchrony QRS 180ms 120ms 2 BNP 167pg/ml 3 CRT 20 1 CRT HR 40bpm AVB cm 42.9kg NYHA 2 48bpm 108/74mmHg X CTR 50.6 LVEF 65.4 LVdD 45mm Holter ECG total HB 65,381/ avg HR 45bpmP rate 167bpm V rate 71bpm 14 DDD LVEF 33 LVDd 50mm CRTspeckle tracking 437ms anterior lateral15 CRT NYHA CRT PMI

9 small PDA PFO23 R N R 8 N 15 R N R N P rate N R V rate N R R N DCR 4 4 N 6 0 R 0 N 10 R 2 6 Ia 1 II 3 III 1 N13 Ia 5 Ib 4 Ic 2 II 12 R II 2 + III 1 N 2 II 2 + II 8 Ib 2 + II + Ib 1 R 8 N 13R N n = R N AVRT 6 EAT 3 MAT 3 AFL 7 JET 1 LQT3 TdP 1 VT MAT 1 AVRT 1 EAT MAT 12 AFL 2 2 LQT3 TdP 1 JET digoxin PAC

10 SVT 1, SVT / digoxin 11 digoxin SVT 21 WPW 3 AET 4 JET 1 AET 2 25 LQT1 2 1 QT QTLQT2LQT3LQT1 2 1 LQT1QT 32 QT follow QT rate 125/min 120/min rate 40/min ,749g Apgar score 7 /9 QTc 510msec QT 9 torsade de pointes LQT1 2 1 QT LQT1 LQT1 2 1 case

11 / 3, / narrow QRS wide QRS XCTR 64 BNP 8,870pg/mlT > 2.0ng/ml 90 / / 1 c 4 1 VT PVC 7 12 JET ATP 19 JET JET 39 NTB3 JET 27 3 SVT EAT JET MAT SVT bpmMAT 5 JET bpm narrow QRS ATP DC SVT bpm narrow QRSATP JET SVT 28 Verapamil incessant VT incessant VT verapamil ,524g QRS 0.08 VT ATP VT /

12 743 10Holter VT ATP lidocaine procainamide propranolol mexiletine pilsicainide lidocaineprocainamidepropranolol VT 1 verapamil 30VT verapamil VT verapamil VTverapamil 29 WPW 2 WPW HCM HCM WPW WPW ECG HCM 47 1 HCM 8 HCM 2 10HCM WPW 7 10 WPW wide QRS tachycardia 1 nonreentrant supraventricular tachycardia NRSVT1 fast pathway slow pathway 2 wide QRS tachycardianrsvt 1 13 AV 1 2 narrow QRS tachycardia wide QRS tachycardia double response ATP PR 140ms 520ms narrow QRS tachycardia NRSVTwide QRS tachycardia NRSVT slow pathway modification 7.5mg Ca120mg wide QRS tachycardia NRSVT ATP wide QRS tachycardia

13 744 31Mahaim 1 PRQRS LBBB Mahaim Mahaim 16 PR QRS Ebstein LBBB A-VHis QRS ATP narrow QRS Mahaim narrow QRS tachycardia CS AP AVRTLBBB wide QRS tachycardia AVRT MahaimAPAVRT CARTO AP Mahaim Mahaim Mahaim 32 Fontan APC atrio-pulmonary connection Fontan APC atrio-pulmonary connection IART RFCA APC 2 14 IARTAPC 6 19 electro-anatomical mapping 10 8 scar10 8 IART5 2 IART 2 IART RFCA IART scar RFCA IART7 TCPC total-cavo pulmonary connection 7 3 TCPC APC TCPC conversion 33 Electroanatomic mapping system BNP 204.8pg/ml 170bpm narrow QRS tachycardia procainamide disopyramide 3 120cm 20.2kg propranolol 50mg digoxin 0.15mg disopyramide 200mg 7Fr 4Fr 10 5Fr 4 pacing bpm warm up P activation sequence mapelectroanatomic mapping system EMS activation map CL 380mspropagation map SN isoproterenol 0.02eg/kg/minpacemaker shift 20Wacceleration 3 SN EMS

14 pause 3 5 AFL EPS JRT 4.9 PM 3 8 AFL RFA XCTR 0.55 EPS #1 session ISP 0.33eg/min CARTOpropagation mapping common AFL block line RFA#1 session AFL 1 RFA #2 sessionisp 0.33eg/min AFLpost pacing interval PPIAFL Brockenbrough 35.twin AV node warm up & cool down narrow QRS 5 HR 240bpm narrow QRS Glenn EPS EPS 12 P QRS II III avfrs 2 Navi- Star7 Fr EPS 2 His QRS narrow QRS QRS 2 twin AVN

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抄 録 第 13 回日本小児心電学研究会 PEDIATRIC CARDIOLOGY and CARDIAC SURGERY VOL. 25 NO. 5 ( ) VSD Brugada 1 Brugada Brugada = mm 5mm Qp/Q

抄録第 13 回日本小児心電学研究会 PEDIATRIC CARDIOLOGY and CARDIAC SURGERY VOL. 25 NO. 5 ( ) VSD Brugada 1 Brugada Brugada = mm 5mm Qp/Q