Ventricular paired pacing to control rapid ventricular heart rate following open heart surgery. Observations on ectopic automaticity. Report of a case in a four-month-old patient.
Ventricular paired pacing to control rapid ventricular heart rate following open heart surgery. Observations on ectopic automaticity. Report of a case in a four-month-old patient.
复制标题
心室配对起搏以控制心脏直视手术后快速心室心率。
作者：
A. Waldo;E. Krongrad;J. Kupersmith;O. R. Levine;F. Bowman;B. Hoffman
一个不寻常的情况下，房室（A-V）交界性心动过速的速度为285次/分钟，在术后立即开发期手术修复（芥末程序）的大血管转位在一个四个月大的婴儿。在此心率下，收缩压降至35-40 mm Hg，尿量停止。心室配对起搏成功地使机械有效心室率减半。这导致了临床有效的血压和正常尿量的恢复。房室交界性心动过速的临床过程及其对几种干预的反应表明，房室交界性心动过速的机制是自动的，而不是折返性的。研究表明，心室配对起搏控制心律失常是一个有用的临床技术，在选定的情况下。
An unusual case is presented in which an atrioventricular (A-V) junctional tachycardia at a rate of 285 beats/min developed in the immediate postoperative period following surgical repair (a Mustard procedure) of transposition of the great vessels in a four-month-old infant. With that heart rate the systolic blood pressure bacame 35-40 mm Hg and urinary output ceased. Ventricular paired pacing was employed successfully to halve the mechanically effective ventricular rate. This resulted in a clinically effective blood pressure and return of normal urinary output. The clinical course of the A-V junctional tachycardia, plus its response to several interventions, suggested that the mechanism of the A-V junctional tachycardia was automatic rather than re-entrant. The study demonstrates that ventricular paired pacing for the control of cardiac arrhythmias is a useful clinical technique in selected cases.