Department of Cardiology, Tianjin Chest Hospital, Tianjin, China.
Ann Noninvasive Electrocardiol. 2023 Jul;28(4):e13064. doi: 10.1111/anec.13064. Epub 2023 May 8.
Ivabradine reduces the heart rate by selectively inhibiting the I current of the sinoatrial node, mainly for the treatment of chronic heart failure with decreased left ventricular systolic function and inappropriate sinus tachycardia, but the inhibitory effect on the atrioventricular node is rarely reported. The patient was admitted to hospital mainly because of intermittent chest pain for 7 years, which worsened for 10 days. Admission electrocardiogram (ECG) considered sinus tachycardia, with QS wave and T wave inversion in II, III, aVF, V R-V R, V -V leads, and non-paroxysmal junctional tachycardia (NPJT) with interference atrioventricular dissociation. After treatment with ivabradine the ECG returned to normal conduction sequence. NPJT with interference atrioventricular dissociation is a fairly rare electrocardiographic phenomenon. This case reports for the first time that ivabradine is used in the treatment of NPJT with interference atrioventricular dissociation. It is speculated that ivabradine has a potential inhibitory effect on the atrioventricular node.
伊伐布雷定通过选择性抑制窦房结的 I 电流来降低心率,主要用于治疗伴有左心室收缩功能降低和不适当窦性心动过速的慢性心力衰竭,但对房室结的抑制作用很少有报道。该患者因间歇性胸痛 7 年,加重 10 天而主要入院。入院心电图(ECG)考虑窦性心动过速,Ⅱ、Ⅲ、aVF、V R-V R、V -V 导联 QS 波和 T 波倒置,呈非阵发性交接性心动过速(NPJT)伴干扰性房室分离。给予伊伐布雷定治疗后,心电图恢复正常传导顺序。NPJT 伴干扰性房室分离是一种相当罕见的心电图现象。本病例首次报道伊伐布雷定用于治疗 NPJT 伴干扰性房室分离。推测伊伐布雷定对房室结有潜在的抑制作用。