Department of Cardiology, People's Hospital of Yuxi City, Yuxi 653100, China.
Ann Transl Med. 2015 Dec;3(21):341. doi: 10.3978/j.issn.2305-5839.2015.11.35.
Over the past few decades, recent developments in pacemaker technology from fixed-rate single-chamber pacemakers to dual chamber pacemakers with pacing algorithms have changed the therapeutic landscape resulting in better healthcare outcomes by improving rate response with minimal ventricular pacing. Here, we share our longest clinical experience with an elderly Chinese male patient who was diagnosed with third-degree atrioventricular (AV) block and was admitted in our hospital 33 years ago. An 85-year-old male patient from China was hospitalized due to dizziness and syncope, with an initial diagnosis revealing third-degree AV block with a heart rate of 35-40 beats per minute (bpm) along with Aase's syndrome and primary hypertension. A single-chamber pacemaker (VVI) was implanted immediately giving the patient symptomatic relief. However, 5-year post-surgery VVI was replaced due to battery exhaustion, while the primary electrode catheter was kept in use. Few years later, the patient again complained of dizziness and re-examination revealed VVI battery debilitation due to premature battery exhaustion. Single-chamber pacemaker was again implanted via the same position of right upper chest. However, after adjusting the frequency of stimulation of the pacemaker to 70 bpm, patient had a symptomatic relief. Considering the severity of patient's disease and knowing that cardiac dysfunction was reported previously, a tri-chamber pacemaker was chosen to take place of previous single-chamber pacemaker. For 33 years, the patient underwent 7 times replacement of pacemaker for battery exhaustion or inadequacy. We successfully performed overall seven pacemaker implantations and upgradation in an elderly Chinese patient diagnosed with third-degree AV block for 33 years. A long following up till now demonstrated no major complications with normal heart rate functioning.
在过去的几十年中，起搏器技术从固定频率的单腔起搏器发展到具有起搏算法的双腔起搏器，这些最新进展改变了治疗格局，通过最小化心室起搏来改善心率反应，从而带来更好的医疗保健效果。在这里，我们分享了一位 85 岁的中国男性患者的最长临床经验，他在 33 年前被诊断为三度房室（AV）阻滞，并入住我院。一位 85 岁的中国男性患者因头晕和晕厥住院，初步诊断为三度 AV 阻滞，心率为 35-40 次/分钟（bpm），伴有 Aase 综合征和原发性高血压。立即植入了单腔起搏器（VVI），使患者症状得到缓解。然而，5 年后由于电池耗尽，更换了 VVI，而最初的电极导管仍在使用。几年后，患者再次出现头晕，再次检查发现由于电池过早耗尽，VVI 电池衰竭。再次通过右上胸部的同一位置植入单腔起搏器。然而，将起搏器的刺激频率调整为 70 bpm 后，患者的症状得到缓解。考虑到患者病情的严重程度，并且知道之前曾报告过心脏功能障碍，选择了三腔起搏器代替以前的单腔起搏器。33 年来，患者因电池耗尽或不足进行了 7 次起搏器更换。我们成功地为一位被诊断为三度 AV 阻滞 33 年的中国老年患者进行了 7 次起搏器植入和升级。迄今为止，长达 33 年的随访没有出现重大并发症，心率功能正常。
