Rubin D A, Nieminski K E, Woolf P, Herman M V
Department of Medicine, New York Medical College, Westchester County Medical Center, Valhalla 10595.
Pacing Clin Electrophysiol. 1988 Nov;11(11 Pt 1):1529-32. doi: 10.1111/j.1540-8159.1988.tb06269.x.
Thirteen patients with recurrent unexplained syncope or presyncope underwent electrophysiological evaluation. A prolonged effective refractory period and functional refractory period of the atrioventricular node as well as slow paced rate to atrioventricular block were the only abnormalities found. Ventricular tachycardia could not be induced. All electrophysiological abnormalities reverted to normal following atropine administration. These patients have selective hypervagotonia isolated to the atrioventricular node. Three of thirteen patients required permanent pacing, and one required propantheline to control recurrent symptoms. Selective hypervagotonia may be a distinct clinical entity that can cause symptoms and require therapy.
13例反复出现不明原因晕厥或先兆晕厥的患者接受了电生理评估。仅发现房室结有效不应期和功能不应期延长以及房室传导阻滞时心率缓慢。未能诱发室性心动过速。给予阿托品后，所有电生理异常均恢复正常。这些患者存在局限于房室结的选择性迷走神经张力亢进。13例患者中有3例需要永久起搏，1例需要丙胺太林来控制反复出现的症状。选择性迷走神经张力亢进可能是一种独特的临床病症，可导致症状并需要治疗。
