Benchimol C B, Schlesinger P, Ginefra P, Barbosa S, Saad E A, Benchimol A B
Acta Cardiol. 1975;30(4):313-22.
The authors present a case of permanent atrial standstill with syncopal attacks, in a patient with chronic Chagas' Heart Disease. The recognition of this dysrhythmia was based upon the conventional and intracavity electrocardiographic tracings in addition to phonomecanographic and hemodynamic data. The recording of the His Bundle electrogram demonstrated the absence of atrial activity, with the His potential preceding all ventricular complexes and an advanced conduction defect distal to the bundle of His. A diffuse type of atrial involvement was suggested by the lack of response to pacemaker stimulation. An increase in ventricular rate following intravenous atropine administration, led to the diagnosis of an a-v junctional rhythm with a widened QRS complex due to an associated right bundle branch block. Following the implantation of an epicardial ventricular pacemaker, the patient became completely asymptomatic despite the persistence of electrical and mechanical atrial standstill.
作者报告了一例患有慢性恰加斯心脏病的患者出现永久性心房停搏并伴有晕厥发作的病例。除了心音图和血流动力学数据外，这种心律失常的识别还基于传统心电图和心腔内心电图描记。希氏束电图记录显示无心房活动，希氏电位先于所有心室复合波出现，且希氏束远端存在高级传导缺陷。对起搏器刺激无反应提示为弥漫性心房受累。静脉注射阿托品后心室率增加，导致诊断为房室交界性心律，伴有因合并右束支传导阻滞而增宽的QRS复合波。植入心外膜心室起搏器后，尽管心房电活动和机械活动持续停搏，但患者完全无症状。
