病态窦房结综合征患者的传导障碍

Conduction Defects in Sick Sinus Syndrome

病态窦房结综合征(简称病窦征)是一组病因不详的临床常见疾病。早在1915年Eystern等人就注意到窦房传导阻滞者常合并房室传导障碍。近年来随着临床电生理学研究的开展,对病窦征同时合并的心脏其它部位传导障碍,有了更为全面的认识。

29 patients with sick sinus syndrome were examined with surface electrocardiogram, His bundle electrocardiogram, right atrial overdrive pacing and programmed stimuli, Among them, two cases had first degree and complete atrioventricular nodal block, one case had complete left bundle branch block, two cases had imcomplete right bundle branch block, one case had P-A interval prolongation, three cases had permanant atrial standstill, 7 cases had H-V interval prolongation, and one case had intrahisian block. 7 cases had A-V node conduction defects with Wenckebach phenomenon at atrial pacing rate≤130 b.p.m. In our series we found 18 cases with 24 sites of conduction defect or block. Meanwhile we had studied the relationship between sinoatrial conduction time (SACT) and A-V conduction defect, but no close relationship between them was found.Basing on the clinical examinations, we assumed that the multipe-sites of conduction defect or block in most cases may be the result of chronic myocardial fibrilization or degeneration.