Pittman D E
Angiology. 1976 Apr;27(4):243-54. doi: 10.1177/000331977602700406.
The bradycardia-tachycardia syndrome (paroxysmal supraventricular tachycardia alternating with sinus bradycardia and episodes of sinus node arrest) has previously presented a complicated therapeutic dilemma when excitatory and suppressive drugs have been utilized. A patient with this syndrome successfully treated with a permanent ventricular transvenous demand pacemaker is presented. Various aspects of this syndrome as well as facets of diagnosis and treatment have been reviewed and discussed. Significant underlying cardiac disease was ruled out in this patient by the usual diagnostic methods including left heart catheterization and coronary angiography. An interesting possibility of the relationship of vagal stimulation secondary to hiatus hernia as an etiologic factor in this syndrome has been discussed. The opinion is expressed that the currently preferred method of treatment is the insertion of a permanent transvenous pacemaker alone or in conjunction with antiarrhythmic drugs, preferably digitalis and propranolol.
心动过缓 - 心动过速综合征（阵发性室上性心动过速与窦性心动过缓及窦房结停搏发作交替出现）以往在使用兴奋性和抑制性药物时会带来复杂的治疗难题。本文介绍了一名通过永久性经静脉按需起搏器成功治疗的该综合征患者。对该综合征的各个方面以及诊断和治疗要点进行了回顾和讨论。通过包括左心导管检查和冠状动脉造影在内的常规诊断方法排除了该患者存在重大潜在心脏疾病。文中讨论了继发于食管裂孔疝的迷走神经刺激作为该综合征病因的一种有趣可能性。文中认为，目前首选的治疗方法是单独植入永久性经静脉起搏器或与抗心律失常药物联合使用，最好是洋地黄和普萘洛尔。
