Kofflard M, De Boer H, van Mechelen R
Pacing Clin Electrophysiol. 1986 Nov;9(6):908-11. doi: 10.1111/j.1540-8159.1986.tb06639.x.
In this report we present the case of a patient with recurrent syncopal episodes. During one of the attacks the patient was monitored by telemetry and the ECG lead showed asystole for more than 7 seconds. As in cases of the cardioinhibitory type of hypersensitive carotid sinus syndrome (HCSS), asystole may represent suppression of the sinus node or suppression of both sinus and atrioventricular (AV) node. Unfortunately, in contrast to HCSS, there is no maneuver that can reproducibly induce episodes of asystole. Consequently, very little is known about the occurrence of AV block in the presence of sinus arrest. In the patient described in this report, we were able to demonstrate that suppression of sinus and AV nodes occurred simultaneously. It is interesting to note that in this type of syncope data from noninvasive and invasive techniques in assessing sinus nodal and AV nodal conduction may not be conclusive. In the group of patients with this type of syncope, permanent atrial demand pacing is contraindicated.
在本报告中，我们介绍了一位反复出现晕厥发作的患者的病例。在其中一次发作期间，通过遥测对患者进行监测，心电图导联显示心脏停搏超过7秒。如同心脏抑制型颈动脉窦过敏综合征（HCSS）的情况一样，心脏停搏可能代表窦房结受抑制或窦房结和房室（AV）结均受抑制。不幸的是，与HCSS不同，没有任何手法能够可重复地诱发心脏停搏发作。因此，对于在窦性停搏情况下房室传导阻滞的发生情况知之甚少。在本报告中描述的患者中，我们能够证明窦房结和房室结同时受到抑制。值得注意的是，在这类晕厥患者中，非侵入性和侵入性技术在评估窦房结和房室结传导方面的数据可能并不具有决定性。在这类晕厥患者组中，永久性按需心房起搏是禁忌的。
