心脏起搏防治血管迷走性晕厥的研究

目的探讨应用双腔起搏器治疗血管迷走性晕厥(VVS)的效果。方法对上海胸科医院心内科经临床和直立倾斜试验明确诊断为VVS的患11例(心脏抑制型7例,混合型4例),均置入了双腔起搏器,其中9例具有频率骤降反应功能。所有患结合13受体阻滞剂进行治疗。患出院后1、3、6、12、24个月分别随访,观察对晕厥的预防效果,分析起搏器自动存储的资料。结果所有患均未再发生晕厥,其中4例仍有晕厥发生前不适,但症状明显减轻;6例患重复直立倾斜试验,可见当心率突然骤降至起搏程控参数时,起搏器可以即时反应,进行快速起搏,起到了防止晕厥发生的作用。结论对于那些反复发作、以心脏抑制为主的VVS患,安装具有频率骤降反应功能的双腔起搏器可以有效防止晕厥的发生。

Dual chamber pacing for vasovagal syncope

Objective To investigate the effect of DDD pacing on vasovagal syncope(VVS). Methods Eleven patients diagnosed VVS (7 with heart inhibiton type, 4 with combination type)by tilt table test (TTT) in Shanghai Chest Hospital were selected into the study .They all were implanted DDD pacemaker in whom 9 with rate-drop response(RDR) function. All of them were prescribed beta-receptor blocker. The patients were followed-up at 1,3,6,12,24 months after being discharged. Results All the 11 patients with pacemaker implantation were free from syncope, in whom 4 still had pre-syncope discomfort, but the symptoms were slightly. Six patients took TTT again after pacemaker implantation. It was observed that pacing at an elevated rate started immediately when heart rate dropping to the lower threshold , and as a result syncope were prevented. Conclusion In the VVS patients with recurrent syncope and severe heart inhibition, DDD pacing with RDR function could prevent from syncopy efficiently.