Paroxysmal Atrioventricular Block in Young Patients1

Paroxysmal Atrioventricular Block in Young Patients1
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年轻患者的阵发性房室传导阻滞1

DOI:
10.1007/s00246-004-0647-z
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发表时间:
2004
影响因子:
1.6
通讯作者:
F. Drago
F. Drago
中科院分区:
医学4区
文献类型:
--
作者:
Massimo Stefano Silvetti;G. Grutter;V. D. Di Ciommo;F. Drago

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我们描述了17例患者(8名女孩和9名男孩),年龄9.6岁, ± 5.7岁,患有阵发性房室传导阻滞(PAVB),这是一种在儿童中很少描述的疾病。霍尔特动态心电图显示PAVB 15例,倾斜试验4例(1例阳性)。7例心电图正常。获得性心脏病2例,先天性心脏病11例。7例患者出现晕厥或晕厥前期。 有症状的患者ECG正常的频率明显更高。女孩和5岁以下儿童的停顿时间明显更长。6例患者仅在夜间记录PAVB,其他患者在全天记录PAVB。PAVB期间,6例患者的窦性心率降低,4例患者的窦性心率升高(通常为有症状的年轻女孩)。13例患者植入永久起搏器,其中7例无症状冠心病伴严重心动过缓患者。随访期间(3.7 ± 2.5年),1例患者发生完全AVB。尽管91%的起搏患者仍然存在PAVB,但由于起搏防止了暂停,因此症状没有复发。总之,PAVB是一种罕见的心律失常。自主神经系统功能障碍似乎在病因学中起作用,永久起搏是一种有效的治疗方法。
We describe 17 patients (8 girls, and 9 boys), aged 9.6 ± 5.7 years, with paroxysmal atrioventricular block (PAVB), a condition rarely described in children. Holter monitoring documented the PAVB in 15 patients, and tilt test was performed in 4 patients (positive in 1). The electrocardiograph (ECG) was normal in 7 patients. Two patients had acquired and 11 patients had congenital heart disease (CHD). Syncope or presyncope were present in 7 patients. A normal ECG was significantly more frequent in symptomatic patients. Pauses were significantly longer in girls and in children <5 years. PAVB was recorded only during nocturnal hours in 6 patients and throughout the day in the others. The sinus rate decreased during PAVB in 6 patients and increased in 4 (generally younger girls with symptoms). Permanent pacemakers were implanted in 13 patients, including 7 asymptomatic patients with CHD and severe bradycardia. During follow-up (3.7 ± 2.5 years), 1 patient developed complete AVB. Although PAVB was still present in 91% of paced patients, symptoms did not recur because pacing prevented the pauses. In conclusion, PAVB is a rare arrhythmia. Autonomic nervous system dysfunction seems to play an etiological role and permanent pacing was an effective treatment.
DOI: 10.1007/s00431-003-1326-4
发表时间: 2003-12-01
影响因子: 3.6
作者:
Suzuki, H;Takeuchi, T;Yoshikawa, N
通讯作者: Yoshikawa, N