由于不适当的自动后腹腔室心房耐火期延长而导致 2:1 电子心房阻塞
Pasquale Crea1, Paolo Bellocchi1, Federica Cocuzza1
1Department of Clinical and Experimental Medicine-Cardiology Unit, University of Messina, Messina, Italy.
Pacing and clinical electrophysiology : PACE
|April 7, 2024
概括
一名带着心脏起器的年轻患者由于意外的电子心房 (AV) 阻塞而感到头. 这发生在头部向上倾斜测试期间,尽管有心脏起器.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 医疗器械 医疗器械
背景情况:
- 一名16岁的女性出现了反复出现的头和昏迷前期.
- 该患者有症状的先天性第三级心房 (AV) 阻塞病史.
- 她使用一个在DDD模式下编程的双室心脏起器 (Medtronic Azure XT DR) 进行管理.
研究的目的:
- 为了调查患有双室心脏起器的患者中新发病的前节期的原因.
- 评估心脏起器功能,并确定在生理压力期间与设备相关的潜在并发症.
主要方法:
- 一名16岁的女性患者用双腔心脏起器接受了头部向上倾斜测试 (HUTT).
- 心脏起器设置被编程为DDD模式,最高速度限制为每分钟150拍.
- 在HUTT期间进行了持续的心电图监测,以评估心律和起器功能.
主要成果:
- 在头部向上倾斜测试期间,出现了2:1电子心房 (AV) 阻塞.
- 这种意想不到的 AV 阻塞发生在每分钟 130 拍的鼻腔频率下.
- 这些发现表明,鼻节功能和在压力下起器行为之间可能存在相互作用.
结论:
- 这项研究强调了电子心血管阻塞在依赖心脏起器的患者中异常的表现.
- 抬头倾斜测试可以揭开心脏起器故障或编程问题.
- 在类似的情况下,进一步调查节拍器编程和AV导电动力学是有必要的.
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