摘要
血管迷走性晕厥(VVS)是一种神经心源性晕厥,其中心脏抑制型和混合型均伴有心率骤降,起搏介入治疗可能有效。文章报道采用频率骤降反应起搏器对2例反复发作VVS患者的治疗情况。患者发作前有头晕、心悸等先兆症状,发作时伴抽搐、尿失禁;心电图及24 h动态心电图未见特征性改变;直立倾斜试验阳性和阴性各1例。患者植入双腔起搏器(DDDR)后开启频率骤降功能。术后随访有频繁抗频率骤降起搏介入,患者症状改善,未出现晕厥。具有频率骤降反应、频率平稳、感知dp/dt的频率反应起搏治疗VVS较单纯药物治疗的优势明显,但起搏介入模式和参数应根据个体特点设置,需定期随访进行调整和优化。
Vasovagal syncope （VVS） is a neurocardiogenic syncope. Cardioinhibitory pattern VVS and mixed pattern VVS are complicated with heart rate drop, and may be treated by pacing intervention. The management of two patients with frequent VVS by rate drop response function pacemaker was reported in this paper. Patients experienced intermittent dizziness and palpitation at episode, followed by convulsion and urinary incontinence. There were no specific changes on routine electrocardiogram and 24 h ambulatory electrocardiogram, and tilt table tests were positive in one patient and negative in the other. Patients underwent implantation of dual chamber pacemaker （DDDR） with rate drop response function. There was frequent pacing intervention combating rate drop during follow up after implantation, and the symptoms were improved, with no incidence of syncope. Rate drop response function pacemaker enjoys significant advantages over drug therapy in management of VVS. However, programming and parameters of pacemaker need to be optimized individually and periodically according to clinical findings.
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2010年第3期360-362,共3页
Journal of Shanghai Jiao tong University:Medical Science
