Goyal S L, Lichstein E, Gupta P K, Chadda K D
Am J Med. 1975 Apr;58(4):586-90. doi: 10.1016/0002-9343(75)90136-9.
This 68 year old man had recurrent episodes of paroxysmal atrial tachycardia, probably due to chronic pericarditis, persisting over a 7 year period. These episodes were resistant to all conventional medical therapy and at times produced ischemic chest pain. There was no evidence of Wolff-Parkinson-White syndrome either on the standard electrocardiogram or on the His bundle electrogram performed with atrial pacing. Rapid atrial pacing at a rate of 200/min was found to promptly terminate the tachycardia and restore normal sinus rhythm. Because of the refractoriness of the patient's tachycardia, in addition to the presence of ischemic chest pain during these episodes, a permanent radio frequency triggered atrial pacemaker was inserted which enables him to initiate rapid atrial pacing by pressing an external control. The patient has been maintained on antiarrhythmic medications in an attempt to decrease the frequency of these episodes; during an 8 month follow-up period, he has done well with approximately one episode of tachycardia each month requiring radio frequency atrial pacing for termination.
这位68岁男性反复出现阵发性房性心动过速，可能是由于慢性心包炎所致，这种情况持续了7年。这些发作对所有传统药物治疗均无效，有时还会引发缺血性胸痛。标准心电图及心房起搏时进行的希氏束电图检查均未发现预激综合征证据。发现以200次/分钟的频率进行快速心房起搏能迅速终止心动过速并恢复正常窦性心律。由于患者的心动过速难以控制，且这些发作期间存在缺血性胸痛，因此植入了永久性射频触发心房起搏器，通过按压外部控制器他就能启动快速心房起搏。患者一直服用抗心律失常药物以试图减少这些发作的频率；在8个月的随访期内，他情况良好，每月约有一次心动过速发作，需要进行射频心房起搏来终止。
