Ogata N, Takatori H, Kamijima J, Tatsumi K, Kuriyama T
Kokyu To Junkan. 1989 Jul;37(7):791-5.
A 41-year-old male was admitted to our hospital with congestive heart failure and bronchopneumonia. During hospitalization extreme sinus bradycardia, sinus arrest up to 6.2 seconds and high grade AV block were observed to occur simultaneously with apneic episodes of ECG monitoring. After that, a diagnosis of Pickwickian syndrome was made in this obese patient. In spite of weight reduction, change of sleep position and acetazolamide administration, obstructive sleep apnea and severe bradyarrhythmias were not improve. These severe bradyarrhythmias and ventricular tachyarrhythmias may be one cause of the not infrequent sudden deaths in patients with this Pickwickian syndrome. In addition to the tracheostomy, we propose that implantation of a cardiac permanent pacemaker should be selected for the bradyarrhythmias in association with the Pickwickian syndrome.
一名41岁男性因充血性心力衰竭和支气管肺炎入院。住院期间，心电图监测发现，极度窦性心动过缓、长达6.2秒的窦性停搏和高度房室传导阻滞与呼吸暂停发作同时出现。此后，该肥胖患者被诊断为匹克威克综合征。尽管进行了减重、改变睡眠姿势和给予乙酰唑胺治疗，但阻塞性睡眠呼吸暂停和严重心律失常并无改善。这些严重的缓慢性心律失常和室性快速性心律失常可能是匹克威克综合征患者猝死并不罕见的原因之一。除气管切开术外，我们建议对于合并匹克威克综合征的缓慢性心律失常患者应选择植入心脏永久性起搏器。
