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晕厥与束支传导阻滞：诊断方法

Syncope and bundle branch block : Diagnostic approach.

作者信息

Moya Angel, Rivas-Gandara Nuria, Perez-Rodón Jordi, Franciso-Pascual Jaume, Santos-Ortega Alba, Fumero Patricia, Roca-Luque Ivo

机构信息

Arrhythmia Unit, Cardiology Department, Hospital Universitari Dexeus, Calle Sabino Arana, 5-19-Planta 6, 08028, Barcelona, Spain.

Arrhythmia Unit, Cardiology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.

出版信息

Herzschrittmacherther Elektrophysiol. 2018 Jun;29(2):161-165. doi: 10.1007/s00399-018-0560-4. Epub 2018 Apr 25.

DOI:10.1007/s00399-018-0560-4
PMID:29696347
Abstract

Syncope and bundle branch block are reviewed, addressing their specific clinical characteristics, natural history, initial diagnostic approach and the role and limitations of different diagnostic tests with a special focus on electrophysiological studies and implantable loop recorders. A critical review of the different published strategies to be followed in these patients is made and finally an algorithm of how to manage these patients is proposed.

摘要

本文对晕厥和束支传导阻滞进行了综述，阐述了它们的具体临床特征、自然病史、初始诊断方法以及不同诊断测试的作用和局限性，特别关注电生理研究和植入式循环记录仪。对这些患者应遵循的不同已发表策略进行了批判性综述，最后提出了如何管理这些患者的算法。

相似文献

1
Syncope and bundle branch block : Diagnostic approach.晕厥与束支传导阻滞：诊断方法
Herzschrittmacherther Elektrophysiol. 2018 Jun;29(2):161-165. doi: 10.1007/s00399-018-0560-4. Epub 2018 Apr 25.
2
Clinical impact of the implantable loop recorder in patients with isolated syncope, bundle branch block and negative workup: a randomized multicentre prospective study.植入式循环记录器在孤立性晕厥、束支传导阻滞和阴性检查患者中的临床影响：一项随机多中心前瞻性研究。
Arch Cardiovasc Dis. 2013 Mar;106(3):146-54. doi: 10.1016/j.acvd.2012.12.002. Epub 2013 Feb 23.
3
Syncope and bundle branch block. Diagnostic yield of a stepped use of electrophysiology study and implantable loop recorders.晕厥和束支传导阻滞。电生理研究和植入式循环记录器逐步应用的诊断效果。
Rev Esp Cardiol. 2011 Mar;64(3):213-9. doi: 10.1016/j.recesp.2010.10.016. Epub 2011 Feb 16.
4
Diagnosis, management, and outcomes of patients with syncope and bundle branch block.晕厥伴束支传导阻滞患者的诊断、治疗和结局。
Eur Heart J. 2011 Jun;32(12):1535-41. doi: 10.1093/eurheartj/ehr071. Epub 2011 Mar 28.
5
[Long-term follow-up after implantable loop recorder in patients with syncope: results of a French general hospital survey].[晕厥患者植入式环路记录仪的长期随访：一家法国综合医院的调查结果]
Ann Cardiol Angeiol (Paris). 2012 Nov;61(5):331-7. doi: 10.1016/j.ancard.2012.08.033. Epub 2012 Oct 1.
6
[Management of syncope in clinical practice : What has changed according to the new ESC guidelines 2018?].[临床实践中晕厥的管理：根据2018年欧洲心脏病学会新指南有哪些变化？]
Herz. 2018 Dec;43(8):701-709. doi: 10.1007/s00059-018-4757-4.
7
Pacemaker therapy in syncope.心脏起搏器治疗晕厥。
Cardiol Clin. 2013 Feb;31(1):131-42. doi: 10.1016/j.ccl.2012.10.001.
8
[Progression to 2d and 3d grade atrioventricular block in patients after electrostimulation for bundle-branch block and syncope: a long-term study].[束支传导阻滞和晕厥患者电刺激后进展为二度和三度房室传导阻滞：一项长期研究]
G Ital Cardiol. 1994 Apr;24(4):409-16.
9
Uncommon cause of syncope in patient with bundle branch block and negative electrophysiological study.束支传导阻滞且电生理检查结果为阴性的患者出现晕厥的罕见原因。
Pacing Clin Electrophysiol. 2006 Feb;29(2):211-2. doi: 10.1111/j.1540-8159.2006.00321.x.
10
Management of Patients With Unexplained Syncope: Derivation and Validation of a Simplified 2-Step Diagnostic Approach.不明原因晕厥患者的管理：简化两步诊断方法的推导和验证。
J Am Heart Assoc. 2023 Nov 21;12(22):e031659. doi: 10.1161/JAHA.123.031659. Epub 2023 Nov 20.

引用本文的文献

1
Arrhythmic syncope: From diagnosis to management.心律失常性晕厥：从诊断到管理
World J Cardiol. 2023 Apr 26;15(4):119-141. doi: 10.4330/wjc.v15.i4.119.
2
Sex-Related Differences in Patients With Unexplained Syncope and Bundle Branch Block: Lower Risk of AV Block and Lesser Need for Cardiac Pacing in Women.不明原因晕厥和束支传导阻滞患者的性别差异：女性发生房室传导阻滞的风险较低且心脏起搏需求较少。
Front Cardiovasc Med. 2022 Feb 25;9:838473. doi: 10.3389/fcvm.2022.838473. eCollection 2022.
3
Cardiac monitoring for patients with palpitations.

本文引用的文献

1
Long-Term Outcome of Patients with Bifascicular Block and Unexplained Syncope Following Cardiac Pacing.双分支阻滞合并不明原因晕厥患者心脏起搏后的长期预后
Pacing Clin Electrophysiol. 2016 Oct;39(10):1126-1131. doi: 10.1111/pace.12946. Epub 2016 Sep 22.
2
Syncope in patients paced for atrioventricular block.因房室传导阻滞而接受起搏治疗患者的晕厥
Europace. 2016 Nov;18(11):1735-1739. doi: 10.1093/europace/euv425. Epub 2016 Feb 6.
3
External prolonged electrocardiogram monitoring in unexplained syncope and palpitations: results of the SYNARR-Flash study.
心悸患者的心脏监测。
World J Cardiol. 2021 Nov 26;13(11):608-627. doi: 10.4330/wjc.v13.i11.608.
4
QTc interval evaluation in patients with right bundle branch block or bifascicular blocks.评估右束支传导阻滞或双分支阻滞患者的 QTc 间期。
Clin Cardiol. 2020 Sep;43(9):957-962. doi: 10.1002/clc.23389. Epub 2020 May 19.
不明原因晕厥和心悸的体外长时间心电图监测：SYNARR-Flash研究结果
Europace. 2016 Aug;18(8):1265-72. doi: 10.1093/europace/euv311. Epub 2015 Oct 29.
4
2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC).2015年欧洲心脏病学会（ESC）室性心律失常患者管理和心脏性猝死预防指南：欧洲心脏病学会（ESC）室性心律失常患者管理和心脏性猝死预防特别工作组。认可机构：欧洲儿科和先天性心脏病协会（AEPC）。
Eur Heart J. 2015 Nov 1;36(41):2793-2867. doi: 10.1093/eurheartj/ehv316. Epub 2015 Aug 29.
5
Prognostic value of the electrocardiogram in patients with syncope: data from the group for syncope study in the emergency room (GESINUR).心电图对晕厥患者的预后价值：来自急诊室晕厥研究组（GESINUR）的数据。
Heart Rhythm. 2014 Nov;11(11):2035-44. doi: 10.1016/j.hrthm.2014.06.037. Epub 2014 Jun 30.
6
Twenty-eight years of research permit reinterpretation of tilt-testing: hypotensive susceptibility rather than diagnosis.28 年的研究允许重新解读倾斜试验：低血压易感性而非诊断。
Eur Heart J. 2014 Sep 1;35(33):2211-2. doi: 10.1093/eurheartj/ehu255. Epub 2014 Jun 30.
7
Prevention of syncope through permanent cardiac pacing in patients with bifascicular block and syncope of unexplained origin: the PRESS study.双束支阻滞伴不明原因晕厥患者的永久性心脏起搏预防晕厥：PRESS 研究。
Circ Arrhythm Electrophysiol. 2013 Feb;6(1):101-7. doi: 10.1161/CIRCEP.112.975102. Epub 2013 Feb 6.
8
Empiric pacemaker compared with a monitoring strategy in patients with syncope and bifascicular conduction block--rationale and design of the Syncope: Pacing or Recording in ThE Later Years (SPRITELY) study.晕厥伴双束支传导阻滞患者的经验性起搏器治疗与监测策略比较——晕厥：起搏或在晚年记录（SPRITELY）研究的原理和设计。
Europace. 2012 Jul;14(7):1044-8. doi: 10.1093/europace/eus005. Epub 2012 Feb 8.
9
Electrocardiogram findings in emergency department patients with syncope.急诊科晕厥患者的心电图表现。
Acad Emerg Med. 2011 Jul;18(7):714-8. doi: 10.1111/j.1553-2712.2011.01120.x.
10
Diagnosis, management, and outcomes of patients with syncope and bundle branch block.晕厥伴束支传导阻滞患者的诊断、治疗和结局。
Eur Heart J. 2011 Jun;32(12):1535-41. doi: 10.1093/eurheartj/ehr071. Epub 2011 Mar 28.