Minutiello L
Ospedale di Urbino, Regione Marche, Azienda Sanitaria n. 2.
Minerva Cardioangiol. 1996 Mar;44(3):133-40.
Single-chamber ventricular pacing remains a frequent pacing method for symptomatic bradyarrhythmias. VVI pacing is effective in maintaining an acceptable ventricular rate, preventing severe bradycardia. However it may cause many important symptoms as a consequence of loss atrio-ventricular synchrony. Pacemaker syndrome (i.e. symptoms and signs caused by inadequate timing of atrial and ventricular contractions) may range in severity from vague pacing awareness to congestive heart failure. This event may be related more to retrograde ventricular-atrial conduction than to the absence of atrio-ventricular synchrony. We report 2 cases of VVI pacing complicated by nocturnal dyspnea (sign of congestive heart failure) as severe manifestation of pacemaker syndrome. By implantation of dual-chamber pacemaker, atrio-ventricular synchrony was restored, nocturnal dyspnea disappeared and has not recurred during clinical follow-up (12 and 4 months respectively for the first and second case.
单腔心室起搏仍然是有症状的缓慢性心律失常常用的起搏方法。VVI起搏在维持可接受的心室率、预防严重心动过缓方面是有效的。然而，由于房室同步性丧失，它可能会引起许多重要症状。起搏器综合征（即由心房和心室收缩时间不当引起的症状和体征）的严重程度可能从模糊的起搏感知到充血性心力衰竭不等。该事件可能更多地与逆向室房传导有关，而非与房室不同步有关。我们报告2例VVI起搏并发夜间呼吸困难（充血性心力衰竭的体征）作为起搏器综合征严重表现的病例。通过植入双腔起搏器，恢复了房室同步性，夜间呼吸困难消失，在临床随访期间（第一例和第二例分别为12个月和4个月）未再复发。
