Moles William J, Barnes Anne A, Khan Ahmed, Patel Kashyap, Bos Nadine
Internal Medicine, Edward Via College of Osteopathic Medicine, Salem, USA.
Internal Medicine, Lewis Gale Medical Center, Salem, USA.
Cureus. 2021 Oct 2;13(10):e18438. doi: 10.7759/cureus.18438. eCollection 2021 Oct.
Paroxysmal ventricular standstill (PVS) is an unusual cardiac phenomenon in which the heart experiences episodes of absent ventricular activity despite normal atrial functioning, often leading to cardiac arrest and syncope. In this case, we report the hospital stay of a 70-year-old male who was admitted to the hospital following an episode of near syncope at home. On admission, the patient's initial electrocardiogram (ECG) showed sinus rhythm at 60 beats per minute without atrioventricular (AV) block. However, as orthostatic vitals were obtained, the patient became lightheaded for several seconds upon standing, which was noted to correspond with a nine second episode of asystole on telemetry and spontaneous return to sinus bradycardia afterward. Cardiology was immediately consulted and confirmed the diagnosis of paroxysmal ventricular standstill (PVS). Given continued episodes of PVS, the patient underwent successful urgent dual-chamber pacemaker placement, following which he became asymptomatic with resolution of bradycardia. Given the high mortality risk associated with PVS, this condition is an important differential to consider in any patient presenting with syncope or near syncope of unclear etiology.
阵发性心室停搏（PVS）是一种不常见的心脏现象，即尽管心房功能正常，但心脏仍会出现心室活动缺失的发作，常导致心脏骤停和晕厥。在此病例中，我们报告一名70岁男性患者的住院情况，该患者在家中发生一次接近晕厥的发作后入院。入院时，患者最初的心电图（ECG）显示窦性心律，每分钟60次心跳，无房室（AV）阻滞。然而，在测量直立位生命体征时，患者站立后几秒钟出现头晕，遥测显示这与一段9秒的心脏停搏发作相对应，随后自发恢复为窦性心动过缓。立即咨询心脏病专家，确诊为阵发性心室停搏（PVS）。鉴于PVS持续发作，患者成功接受了紧急双腔起搏器植入，之后他不再有症状，心动过缓也得到缓解。鉴于PVS相关的高死亡风险，在任何病因不明的晕厥或接近晕厥患者中，这种情况都是需要考虑的重要鉴别诊断。
