Stierle U, Potratz J, Taubert G, Mitusch R, Sheikhzadeh A, Diederich K W
Klinik für Kardiologie, Medizinische Universität Lübeck.
Dtsch Med Wochenschr. 1991 Dec 13;116(50):1907-10. doi: 10.1055/s-2008-1063838.
Characteristic signs of the pacemaker syndrome occurred in a 69-year-old woman with intermittent 3 degrees atrioventricular (AV) block after implantation of a dual-chamber AV-synchronized pacemaker. Cannon beats due to inappropriate atrial timing were the main haemodynamic finding. Their development and size depended on the programmed AV interval and AV-synchronized mode of stimulation. Very long AV intervals in the DDD mode at a heart rate of 100/min caused very unpleasant palpitations and pulsations in the upper thorax. The symptoms due to the cannon beats were avoided by changing to a short AV interval. The clinical and haemodynamic events were thus the consequence of preserved sinus node function with subsequent atrial triggering.
一名69岁女性在植入双腔房室同步起搏器后出现间歇性三度房室传导阻滞，出现了起搏器综合征的典型体征。因心房时机不当导致的大炮波是主要的血流动力学表现。其出现及幅度取决于程控的房室间期和房室同步刺激模式。在心率为100次/分钟时，DDD模式下极长的房室间期会导致非常不适的心悸和上胸部搏动。通过将房室间期缩短，避免了由大炮波引起的症状。因此，临床和血流动力学事件是窦房结功能保留并随后触发心房的结果。
