Beaufort-Krol Gertie C M, Stienstra Ymkje, Bink-Boelkens Margreet Th E
Beatrix Children's Hospital, Division of Pediatric Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.
Europace. 2007 Sep;9(9):844-7. doi: 10.1093/europace/eum116. Epub 2007 Jun 4.
Children with congenital complete atrioventricular block (CCAVB) often need pacemaker therapy. In these children, it may be preferable to use single-lead VDD pacing, but for VDD pacing a normal sinus node function is required. Our aim was to study sinus node function in children with CCAVB.
We longitudinally evaluated sinus rate in 36 children with CCAVB and normal anatomy of the heart. The rate of sinus rhythm on a 12-lead ECG, in Holter recordings, and exercise tests were evaluated at regular intervals. Age at the first visit of the children was 2.5+/-3.3 years (mean+/-SD). Follow-up was 10.6+/-7.3 years. The rate of sinus rhythm on a 12-lead ECG was at every age within the normal values for age (e.g. 0-1 year: 153+/-24 bpm, and 17-18 years: 76+/-4 bpm). Lowest and highest sinus rates in the Holter recordings were normal. During exercise, mean sinus rate in the total group of children increased from 92+/-8 at rest to 171+/-9 bpm at maximal exercise.
We conclude that sinus node function is normal in children with CCAVB. Because of the normal increase in sinus rate during exercise, a single-lead VDD pacemaker can be safely implanted in these children.
先天性完全性房室传导阻滞（CCAVB）患儿常需起搏器治疗。对于这些患儿，使用单导联VDD起搏可能更为可取，但VDD起搏需要正常的窦房结功能。我们的目的是研究CCAVB患儿的窦房结功能。
我们纵向评估了36例心脏解剖结构正常的CCAVB患儿的窦性心率。定期评估12导联心电图、动态心电图记录及运动试验中的窦性心律频率。患儿首次就诊时的年龄为2.5±3.3岁（均值±标准差）。随访时间为10.6±7.3年。12导联心电图上的窦性心律频率在各年龄段均处于该年龄的正常范围内（例如，0至1岁：153±24次/分钟，17至18岁：76±4次/分钟）。动态心电图记录中的最低和最高窦性心率均正常。运动期间，患儿总体组的平均窦性心率从静息时的92±8次/分钟增加到最大运动时的171±9次/分钟。
我们得出结论，CCAVB患儿的窦房结功能正常。由于运动期间窦性心率正常增加，因此可以在这些患儿中安全植入单导联VDD起搏器。
