植入心脏起搏器患者晕厥复发的原因分析

Recurrence of syncope after a pacemaker implanted

目的 回顾性分析４３０例心脏起搏患者术后２５ 例再发生晕厥原因，并提出及时有效的处理步骤和措施。方法 全组２５例均为１９８６年１ 月～１９９８ 年６月住院植入ＶＶＩ起搏器患者，其中男性１１例，女性１４ 例，年龄３９～７６ 岁。基础心律失常：病态窦房结综合征１３ 例，三度房室阻滞８ 例，双束支－三分支阻滞４ 例。结果 ２５ 例患者中再晕厥与起搏器有关１４ 例（５６％ ）；快速室性心律失常７ 例（２８％ ）；其他原因４例（１６％ ）。结论 植入永久性心脏起搏器后再晕厥是临床急诊，遇到时应及时找出原因并予以相应处理。

Objective to analyze retrospectly causes of recurrent syncope in 25 cases out of 430 patients with a VVI pacemaker implanted for bradyarrhythmias,and to make a comment on diagnositic approaches and management procedures. Method There were 11 males and 14 females,with age ranging from 39 to 76 years.They received pacemaker implantation for sick sinus syndrome in 13,complete atrioventricular block in 8 and bilateral bandle branch block or trifascicular block in 4 during the period from Jan.1986 to June 1998. Results Among the 25 cases with syncope recurrence,14(56%)were relevant to pacemaker malfunction,7(28%)were due to ventricular tachyarrhthmias and 4(16%)were due to other causes. Conclusion Syncope recurrence after pacemaker implantation is an emergency situation.The inherent causes should be determined and effective corrective measures should be performed in time.After pacemaker implantation,therapies for the basic cardiac disorders should be strenghthened,and treatment and prevention of ventricular tachyarrhthmia,should be emphasized.