Shin H, Higashi S, Kido M, Ninomiya H
Department of Cardiovascular Surgery, Shizuoka Red Cross Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Sep;42(9):1365-9.
The maze procedure was performed simultaneously with mitral valve replacement for atrial fibrillation and mitral stenosis in a 66-year-old female. On the first postoperative day, the cardiac status deteriorated suddenly due to a very rapid heartbeat which was later diagnosed as a 1:1 AV conduction of atrial flutter. The atrial flutter responded to an injection of verapamil and changed to a 2:1 conduction. Although atrial flutter had continued until the thirteenth postoperative day, the heart achieved sinus rhythm on that day. Since then it has continued without any antiarrhythmic drugs except digitalis. It was difficult to make a diagnosis of the rapid heartbeat on the 12-lead ECG because P waves could not be seen clearly on the ECG. Recording the electrical cardiac status by using the temporal atrial pacing leads, which were placed during the operation, was helpful in diagnosing the heartbeat as atrial flutter. The electrophysiological examination eight weeks after the operation revealed that the sinus node function was normal and atrial flutter or atrial fibrillation could not be induced. The patient is well and in sinus rhythm 12 months after the operation.
在一名66岁女性患者中，迷宫手术与二尖瓣置换术同时进行，用于治疗心房颤动和二尖瓣狭窄。术后第一天，患者心脏状况突然恶化，心跳极快，后来被诊断为心房扑动的1:1房室传导。静脉注射维拉帕米后，心房扑动转变为2:1传导。虽然心房扑动一直持续到术后第13天，但当天心脏恢复了窦性心律。从那时起，除了洋地黄外，未使用任何抗心律失常药物，心脏一直维持窦性心律。由于心电图上无法清晰看到P波，因此很难通过12导联心电图诊断快速心跳。利用手术期间放置的临时心房起搏导联记录心脏电活动状态，有助于将心跳诊断为心房扑动。术后8周的电生理检查显示，窦房结功能正常，无法诱发心房扑动或心房颤动。术后12个月，患者情况良好，维持窦性心律。
