Schweitzer P, Stern E H
Cardiology Section, Veterans Administration Medical Center, Bronx, NY 10468.
Pacing Clin Electrophysiol. 1988 Jan;11(1):114-9. doi: 10.1111/j.1540-8159.1988.tb03936.x.
In this report we describe a case of a 68-year-old man with atrioventricular junctional parasystole in whom atrial pacing caused marked changes in the arrhythmic pattern. During atrial pacing at a cycle length of 960 ms, the duration of the ectopic cycle length was influenced by the interval between the parasystolic and nonparasystolic beat. A shorter interval from nonparasystolic to ectopic beat prolonged the ectopic cycle length and a longer one shortened it. Pacing at a cycle length of 900 ms completely suppressed the parasystole. Both of these changes are most likely due to modulation and entrainment of the parasystolic rhythm. During spontaneous variation of the sinus cycle length over 24 hours of ambulatory ECG recording, modulation could not be confirmed; however, there was parallel variation of the ectopic and sinus cycle lengths which suggests that both pacemakers were under the influence of the autonomic nervous system.
在本报告中，我们描述了一例68岁患房室交界性并行心律的男性患者，心房起搏导致其心律失常模式发生显著变化。在以960毫秒的周期长度进行心房起搏时，异位周期长度受并行心律搏动与非并行心律搏动之间的间期影响。从非并行心律搏动到异位搏动的间期较短会延长异位周期长度，而较长的间期则会使其缩短。以900毫秒的周期长度进行起搏可完全抑制并行心律。这两种变化很可能是由于并行心律的调制和拖带所致。在动态心电图记录的24小时内窦性周期长度自发变化期间，无法证实存在调制；然而，异位周期长度和窦性周期长度存在平行变化，这表明两个起搏器均受自主神经系统的影响。
