Ⅰ度房室传导阻滞的并发症:假性起搏器综合征  

Complications of First Degree Atrioventricular Block:Pseudo-pacemaker Syndrome

作　　者：陆定坤 樊晓寒 LU Dingkun;FAN Xiaohan(Center of Arrhythmia,Fuwai Hospital&State Key Laboratory of Cardiovascular Disease,Peking Union Medical College,Chinese Academy of Medical Sciences,National Center for Cardiovascular Diseases,Beijing 100037,China)

机构地区：[1]中国医学科学院、北京协和医学院、国家心血管病中心、阜外医院心律失常中心心血管病国家重点实验室,北京100037

出　　处：《中国分子心脏病学杂志》2024年第5期6424-6429,共6页Molecular Cardiology of China

摘　　要：假性起搏器综合征是在Ⅰ度房室传导阻滞患者中出现的罕见现象,是在没有植入起搏器的情况下,PR间期极度延长导致房室不同步和随后的血流动力学不稳定症状,包括心输出量减少和肺毛细血管楔压增加。病因可归纳为:(1)房室结传导不良;(2)可逆性炎症;(3)医源性手术或介入操作;(4)房室结慢径路传导。假性起搏器综合征最常见的患者年龄段为中青年,平均年龄为50岁,呼吸困难和心悸是假性起搏器综合征的主要临床症状,目前治疗以植入永久起搏器为主,但对于无房室结折返性心动过速表现的房室结慢径路传导所致的假性起搏器综合征尚无明确治疗。为了更好地帮助临床医师识别和管理该综合征,本文对该领域的现有文献进行系统回顾和汇总分析。Pseudo-pacemaker syndrome(PPMS)is a rare occurrence among patients with first-degree atrioventricular block.PPMS is characterized by extreme prolongation of PR interval without the presence of a pacemaker,resulting in atrioventricular asynchrony and subsequent symptoms of hemodynamic instability,including decreased cardiac output and increased pulmonary capillary wedge pressure.The etiology of PPMS can be summarized as follows:AV node dysconductivity,reversible inflammation,medical surgery or intervention,and conduction of atrioventricular nodal slow pathway.PPMS is most common in middle-aged and young adults,with a mean age of 50 years.Dyspnea and palpitations are the main clinical symptoms of PPMS.Currently,treatment for PPMS is based on the implantation of a permanent pacemaker.However,there is no definitive treatment for PPMS due to conduction of atrioventricular nodal slow pathway without the manifestation of AV nodal refractory tachycardia.To assist clinicians in recognizing and managing this syndrome,we conducted a systematic review and pooled analysis of the available literature.

关 键 词：假性起搏器综合征 Ⅰ度房室传导阻滞 心律失常 心脏起搏器 

分 类 号：R541.7[医药卫生—心血管疾病]