Prochaczek F, Matuszewska J, Zalewski J, Surma I
I Kliniki Chorób Wewnetrznych Slaskiej Akademii Medycznej.
Kardiol Pol. 1991;35(11):294-9.
The diagnostic usefulness and safety of non-invasive heart stimulation has been tested on 20 persons with full symptomatic cardiodepressive type of carotid sinus syndrome. The estimation of the cardiodepressive syndrome has been conducted on the grounds of electrophysiological tests of the heart with the method of endocavitary stimulation introduced by Stryjer and adopted by us for non-invasive heart stimulation. Massage of the carotid sinus was performed during sinus rhythm, during transesophageal atrial stimulation and during transcutaneous ventricle stimulation. In 17 persons massage of the carotid sinus caused sinus node inhibition. In this group carotid sinus massage during atrial stimulation revealed a group of 10 persons with only sinus node inhibition (type A) and a group of 7 persons with the coexistence of sinus node inhibition and an AV III block (type C). Only in 3 persons massage of the carotid sinus merely caused an AV III block (type B). Massage of the carotid sinus during transcutaneous ventricle stimulation showed retrograde AV conduction suppression in type B and C of the carotid cardiodepressive syndrome. To recapitulate the obtained results, it can be assumed that electrophysiological estimation of the carotid sinus syndrome is also possible and safe with the non-invasive method. Such procedure can also facilitate the selection of patients for permanent stimulation of AAI type for the type A syndrome or DVV for types B and C.
已对20例具有完全症状性心脏抑制型颈动脉窦综合征的患者进行了无创心脏刺激的诊断效用和安全性测试。心脏抑制综合征的评估是基于心脏的电生理测试进行的，采用了Stryjer引入并经我们用于无创心脏刺激的腔内刺激方法。在窦性心律、经食管心房刺激和经皮心室刺激期间进行颈动脉窦按摩。17例患者中，颈动脉窦按摩导致窦房结抑制。在该组中，心房刺激期间的颈动脉窦按摩显示，一组10例患者仅出现窦房结抑制（A型），另一组7例患者同时存在窦房结抑制和房室Ⅲ度阻滞（C型）。仅3例患者的颈动脉窦按摩仅导致房室Ⅲ度阻滞（B型）。经皮心室刺激期间的颈动脉窦按摩显示，B型和C型颈动脉心脏抑制综合征存在逆行房室传导抑制。总结所获得的结果，可以认为采用无创方法对颈动脉窦综合征进行电生理评估也是可行且安全的。这样的程序还可以便于为A型综合征的患者选择AAI型永久刺激，为B型和C型患者选择DDD型永久刺激。
