ルーチン大腸内視鏡検査中の遷延性完全房室ブロック:伝導系疾患を模倣した良性の迷走神経反射
Sebastian Hernandez Mejia1, Joud Fahed2, Rayna Isber3
1Internal Medicine/Cardiology, Richmond University Medical Center, New York, USA.
Cureus
|January 22, 2026
まとめ
GI処置中の遷延性完全心ブロックはまれで、通常は迷走神経刺激によるものです。この症例は、そのようなイベントが自然に解決し、ペースメーカー移植のような不要な介入を防ぐことが多いことを強調しています。
科学分野:
- 心臓病学
- 消化器病学
- 医療処置
背景:
- 消化管(GI)処置中の完全房室ブロックはまれですが、重要です。
- 鎮静または内視鏡操作による迷走神経刺激が通常の原因です。
- これらのブロックは通常、自然に解決します。
研究 の 目的:
- ルーチンGI内視鏡検査中の遷延性完全房室ブロックの症例を報告すること。
- 迷走神経介在性房室(AV)ブロックの認識の重要性を強調すること。
- 内因性伝導疾患の過剰診断と不要な介入を防ぐこと。
主な方法:
- 68歳の女性の症例報告。
- 麻酔下でのルーチン大腸内視鏡検査および上部内視鏡検査中のモニタリング。
- 介入なしでの調律正常化の観察。
主要な成果:
- 患者は処置中に遷延性の完全房室ブロックを経験しました。
- 彼女の心調律は処置後に自然に正常化しました。
- 薬物療法やペースメーカーは必要ありませんでした。
結論:
- 迷走神経介在性房室ブロックは、GI処置中の良性の反射現象です。
- この遷延性ブロックを認識することは、誤診を避けるために重要です。
- 認識により、不要な評価や恒久的ペースメーカー移植を防ぐことができます。
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