Toloune F, Boukili A, Ghafir D, Hadri L, Chaari J, Akheddiou B, Ohayon V, Archane M I
Service de médecine B, hôpital militaire dínstruction Mohammed V, Rabat, Maroc.
Arch Mal Coeur Vaiss. 1988 Sep;81(9):1131-5.
The authors report the case of a 26-year old male patient who had Graves' disease with a first degree atrioventricular block (AVB) and intermittent episodes of a second degree AVB of the Lucciani-Wenckebach type. These disorders of conduction had features characteristic of a nodal block and disappeared after treatment of the hyperthyroidism. The pathogenesis of atrioventricular conduction disorders in hyperthyroidism remains controverted. The authors put forward the following hypothesis: under the influence of thyroid hormones in excessive amounts, the autonomic nervous system would act by reciprocal excitation and exacerbate a patent or latent hypervagotonia which was pre-existent to the hyperthyroidism. This hypothesis needs to be tested by intracardiac electrophysiological studies with atrial stimulation.
作者报告了一例26岁男性患者，该患者患有格雷夫斯病，伴有一度房室传导阻滞（AVB）以及间歇性的卢奇亚尼 - 温克巴赫型二度AVB。这些传导障碍具有结性阻滞的特征，在甲状腺功能亢进症得到治疗后消失。甲状腺功能亢进症中房室传导障碍的发病机制仍存在争议。作者提出以下假设：在过量甲状腺激素的影响下，自主神经系统会通过相互兴奋起作用，加剧在甲状腺功能亢进症之前就已存在的显性或潜在迷走神经张力亢进。这一假设需要通过心房刺激的心内电生理研究来验证。
