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阵发性房内折返性心动过速期间诱发的阵发性房室传导阻滞。

Paroxysmal atrioventricular block induced during paroxysmal intra-atrial reentrant tachycardia.

作者信息

Honda Nobuhiro, Takase Susumu, Tsutsumi Takaki, Sakemi Takuya, Mikami Takeshi, Mukai Yasushi

机构信息

Division of Cardiology, Fukuoka Red Cross Hospital, Fukuoka, Japan.

Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan.

出版信息

J Cardiol Cases. 2021 May 26;24(5):240-243. doi: 10.1016/j.jccase.2021.04.009. eCollection 2021 Nov.

DOI:10.1016/j.jccase.2021.04.009
PMID:34868406
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8617479/
Abstract

Paroxysmal atrio-ventricular (AV) block is a relatively rare form of bradyarrhythmia that may be caused by vagal reflex, intrinsic His-Prukinje system (HPS) disorder, or idiopathic mechanisms. We report a case with paroxysmal AV block and syncopal episodes that appeared only during intra-atrial reentrant tachycardia (IART) after an ablation procedure. Syncope did not occur under sinus rhythm with stable 1:1 AV conduction. An HPS disorder was proven in an electrophysiological study. It was suggested that paroxysmal AV block was induced via a tachycardia-dependent mechanism with an exacerbation of latent HPS disorder. The occurrence of the IART was only transient, and there was no recurrent syncope during one-year follow-up. Pacemaker implantation could be avoided. < Paroxysmal atrio-ventricular block is a relatively rare form of bradyarrhythmia and can occur only during atrial tachyarrhythmia. Indications for a cardiac implantable electrical device should be carefully considered if the attributed tachycardia is treatable.>.

摘要

阵发性房室传导阻滞是一种相对罕见的缓慢性心律失常形式，可能由迷走神经反射、希氏-浦肯野系统（HPS）固有疾病或特发性机制引起。我们报告一例阵发性房室传导阻滞和晕厥发作的病例，这些症状仅在消融术后房内折返性心动过速（IART）期间出现。在窦性心律且房室传导稳定为1:1时未发生晕厥。电生理研究证实存在HPS疾病。提示阵发性房室传导阻滞是通过心动过速依赖性机制诱发的，伴有潜在HPS疾病的加重。IART的发生只是短暂的，在一年的随访中没有复发性晕厥。可以避免植入起搏器。<阵发性房室传导阻滞是一种相对罕见的缓慢性心律失常形式，且仅在房性快速性心律失常期间发生。如果归因的心动过速是可治疗的，则应仔细考虑心脏植入式电子装置的适应证。>

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5899/8617479/a118b3577ce7/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5899/8617479/27b7cb0443c9/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5899/8617479/980dac2f652e/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5899/8617479/a118b3577ce7/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5899/8617479/27b7cb0443c9/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5899/8617479/980dac2f652e/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5899/8617479/a118b3577ce7/gr3.jpg

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HeartRhythm Case Rep. 2018 Mar 1;4(9):383-385. doi: 10.1016/j.hrcr.2018.02.011. eCollection 2018 Sep.
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Syncope and paroxysmal atrioventricular block.晕厥与阵发性房室传导阻滞。
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Concealed conduction of premature ventricular complexes resulting in AV nodal block.室性早搏的隐匿性传导导致房室结阻滞。
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Unusual mechanism of complete atrioventricular block following atrial flutter ablation.心房扑动消融术后完全性房室传导阻滞的异常机制
HeartRhythm Case Rep. 2015 Jul 17;1(5):369-372. doi: 10.1016/j.hrcr.2015.06.015. eCollection 2015 Sep.
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2013 ESC guidelines on cardiac pacing and cardiac resynchronization therapy: the task force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA).2013年欧洲心脏病学会（ESC）心脏起搏与心脏再同步治疗指南：欧洲心脏病学会（ESC）心脏起搏与心脏再同步治疗特别工作组。与欧洲心律协会（EHRA）合作制定。
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