Libin Cardiovascular Institute of Alberta, Cummings School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Libin Cardiovascular Institute of Alberta, Cummings School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Can J Cardiol. 2018 Aug;34(8):1089.e1-1089.e3. doi: 10.1016/j.cjca.2018.03.019. Epub 2018 Apr 5.
A 58-year-old man with previous mitral/aortic mechanical-valve replacement, aortic root repair, and coronary disease developed severe left-ventricular dysfunction following AV-node ablation/single-chamber pacemaker implantation for management of atrial fibrillation. He then underwent an upgrade to cardiac resynchronization therapy with a defibrillator. To manage his heart failure better, angiotensin-receptor blocker therapy was changed to sacubitril/valsartan, after which symptomatic palpitations with T-wave oversensing occurred. The resolved T-wave oversensing and palpitations stopped upon discontinuation of sacubitril/valsartan and recurred upon rechallenge, requiring a switch back to valsartan monotherapy. Our report presents the first known case of T-wave oversensing due to sacubitril/valsartan.
一位 58 岁男性，既往有二尖瓣/主动脉机械瓣置换、主动脉根部修复和冠状动脉疾病，在行房室结消融/单腔起搏器植入以治疗心房颤动后出现严重左心室功能障碍。随后，他接受了心脏再同步治疗除颤器升级。为了更好地治疗心力衰竭，将血管紧张素受体阻滞剂治疗改为沙库巴曲缬沙坦后，出现了有症状的心悸伴 T 波过感知。停止使用沙库巴曲缬沙坦后，T 波过感知和心悸得到缓解，再次使用后再次出现，需要再次换用缬沙坦单药治疗。我们的报告提出了首例已知的沙库巴曲缬沙坦导致 T 波过感知的病例。
