Department of Medicine, Section of Cardiology, Ospedale Privato Quisisana, Viale Cavour 128, 44121 Ferrara, Italy.
Heart. 2013 Jul;99(13):904-8. doi: 10.1136/heartjnl-2012-303220. Epub 2013 Jan 2.
Vagally mediated atrioventricular (AV) block is defined as a paroxysmal AV block, localised within the AV node, associated with slowing of the sinus rate. All types of second-degree AV block, including pseudo-Mobitz II block, and complete AV block, may be present. Most of the patients have normal AV conduction. Differential diagnosis with intrinsic AV block is based on the behaviour of the sinus rate. Vagally mediated AV block is benign; it can be recorded as an asymptomatic or symptomatic event (syncope/presyncope). Syncope due to this form of AV block should be diagnosed and managed as neurally mediated syncope. When this block is fortuitously recorded in asymptomatic patients, pacemaker implantation is not indicated.
迷走神经介导的房室（AV）阻滞定义为房室结内的阵发性 AV 阻滞，与窦性心动过缓有关。所有类型的二度 AV 阻滞，包括假性二度 II 型阻滞和完全性 AV 阻滞，都可能存在。大多数患者的 AV 传导正常。与内在性 AV 阻滞的鉴别诊断基于窦性心率的变化。迷走神经介导的 AV 阻滞是良性的；它可以作为无症状或有症状的事件（晕厥/晕厥前状态）记录。由于这种形式的 AV 阻滞引起的晕厥应作为神经介导性晕厥进行诊断和治疗。当这种阻滞在无症状患者中偶然记录到，不需要植入起搏器。
