Wu J M, Young M L, Wu M H, Wang J K, Lue H C
Department of Pediatrics, National Taiwan University Hospital, Taipei, R.O.C.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1991 Jan-Feb;32(1):1-8.
Atrial flutter (AF) is a potentially dangerous arrhythmia in children, which is difficult to be converted into sinus rhythm by drug therapy alone. In four young patients (3 had history of cardiac surgery, 1 had Ebstein's anomaly), the AF which had failed to medical therapy was converted into sinus rhythm by an intracardiac atrial pacing: In two patients the AF was terminated by atrial pacing alone, and in the other two the AF was converted into sinus rhythm by atrial pacing after procainamide infusion. In all patients an entrainment of AF was observed during the atrial pacing, which favored a reentrant mechanism for the AF in these patients. Evidences of sinus node dysfunction were observed in all three postoperative patients. We conclude that atrial pacing with or without procainamide infusion is an effective method for the conversion of atrial flutter. In addition, for patients with AF and concomitant sinus node dysfunction, this method can ensure the patients' safetiness.
心房扑动（AF）在儿童中是一种潜在危险的心律失常，仅通过药物治疗很难转为窦性心律。在4例年轻患者（3例有心脏手术史，1例有埃布斯坦畸形）中，药物治疗无效的AF通过心内心房起搏转为窦性心律：2例患者仅通过心房起搏终止AF，另外2例在输注普鲁卡因酰胺后通过心房起搏转为窦性心律。在所有患者的心房起搏过程中均观察到AF的拖带现象，这支持这些患者的AF存在折返机制。在所有3例术后患者中均观察到窦房结功能障碍的证据。我们得出结论，无论是否输注普鲁卡因酰胺，心房起搏都是转复心房扑动的有效方法。此外，对于合并窦房结功能障碍的AF患者，该方法可确保患者的安全。
