Benmimoun E G, Adamec R, Rutishauser W
Arch Mal Coeur Vaiss. 1982 Dec;75(12):1381-7.
Cutaneous electrical stimulation allows inhibition of permanent on-demand cardiac pacemakers. The evolution of the spontaneous cardiac rhythm was studied, using this technique of inhibition in 164 patients paced for 4 to 16 years. At implantation, 117 patients (70 p. 100) had atrioventricular block, 45 patients (27 p. 100) had sinoatrial dysfunction and 2 patients had a carotid sinus syndrome. Of these 164 patients, 153 were symptomatic. Three groups were distinguished: - 41 patients (25 p. 100) with a spontaneous ventricular rhythm at each check-up; - 75 patients (46 p. 100) with an underlying ventricular rhythm recorded when the pacemaker was inhibited by cutaneous electrical stimulation; - 48 patients (29 p. 100) with no underlying ventricular rhythm during 3 successive inhibitions of their pacemakers of 3 to 4 seconds duration on each occasion. All these patients had atrioventricular block at implantation; none had sinoatrial disease. In conclusion, disease of the atrioventricular conduction pathway, contrary to sinoatrial disease, leads to a prolonged absence of the spontaneous ventricular activity. This seems to be related to a longer survival of patients without associated pathology, and also suggests a degenerative cause of the atrioventricular block.
皮肤电刺激可抑制永久性按需心脏起搏器。采用这种抑制技术，对164例起搏4至16年的患者的自发心律演变情况进行了研究。植入时，117例患者（70%）患有房室传导阻滞，45例患者（27%）患有窦房结功能障碍，2例患者患有颈动脉窦综合征。在这164例患者中，153例有症状。分为三组：- 每次检查时均有自发室性心律的41例患者（25%）；- 通过皮肤电刺激抑制起搏器时记录到有潜在室性心律的75例患者（46%）；- 每次连续3至4秒抑制起搏器3次期间均无潜在室性心律的48例患者（29%）。所有这些患者植入时均有房室传导阻滞；无一例患有窦房结疾病。总之，与窦房结疾病相反，房室传导通路疾病会导致自发室性活动长期缺失。这似乎与无相关病变患者的较长生存期有关，也提示了房室传导阻滞的退行性病因。
