阵发性完全性房室传导阻滞致心源性晕厥50例临床研究

目的通过对50例阵发性完全性房室传导阻滞所致心源性晕厥的资料进行分析,总结其临床及心电图特点。方法收集2001年1月至2014年1月50例诊断为阵发性完全性房室传导阻滞致心源性晕厥患者入院资料,包括一般临床资料、心电图、超声心动图、X线胸片、24 h动态心电图及心内电生理检查等。分析其资料特点。结果 50例患者中,20例伴有缺血性心脏疾病,18例房室传导阻滞患者服用β受体阻滞剂,12例患者在急性心肌梗死恢复过程中发生完全性房室传导阻滞,3例发生在慢性头痛过程中,5例发生在主动脉瓣置换术后。所有患者的发生时间从2.2~15 s不等。16例患者的心电图显示宽QRS波形。及时的处理措施包括静脉补液及阿托品注射、停服β受体阻滞剂、植入临时心脏起搏器等。结论完全性阵发性房室传导阻滞与迷走神经反应、影响房室传导药物和传导系统疾病有关,大多数患者最终需要植入永久性心脏起搏器。

Paroxysmal complete atrioventricular block induced syncope analysis of 50 cases

Objective To summarize the clinical and ECG characteristics,by analyzing 50 patients with paroxysmal complete atrioventricular block caused by cardiogenic syncope. Methods From in 2001 January to 2014 year in January,50 cases of hospital diagnosed as paroxysmal complete atrioventricular block induced syncope patients were included into this study. The clinical data,electrocardiogram,echocardiogram,X-ray,24 h Holter and cardiac electrophysiology examination were collected and analyzed. Results 20 of 50 cases was diagnosed as ischemic heart disease,18 patients taking β-blockers,12 patients with complete atrioventricular block in patients with acute myocardial infarction during the recovery process,three occurred in the course of chronic headaches,five occurred in the aortic valve replacement surgery. Time of occurrence of all patients ranged from 2. 2 s to 15 s,16 patients associated with wide QRS ECG waveform. Timely treatment measures included intravenous fluids and atropine injection,stopped taking β-blockers,a temporary pacemaker implanted and so on. Conclusion Complete atrioventricular block associated with paroxysmal vagal reactions,atrioventricular conduction blocking drugs and clinical symptoms of the disease. Most patients eventually require a permanent pacemaker implantation.