孤立性心肌致密化不全伴心动过缓的起搏器治疗分析

Pacemaker in Treatment of Isolated Ventricular Noncompaction Accompanying Bradycardia

目的探讨起搏器治疗孤立性心肌致密化不全(IVNC)伴心动过缓的疗效。方法 4例IVNC伴心动过缓患者均为成人(29～52岁):窦性心动过缓1例,窦性静止1例,窦性心动过缓并交界心律1例,持续心房纤颤伴心室长间歇1例。其中3例因服用胺碘酮或β-受体阻滞剂后出现心动过缓。4例均行起搏器植入,3例为双腔起搏器(DDD),1例为单腔起搏器(VVI)。术后均重新服用抗心律失常药物。平均随访49个月。结果 4例均未出现心动过缓,仅出现室性期前收缩。其中1例发生持续性心房纤颤6个月后转为窦性心律,未继续行药物治疗于第15个月猝死。结论起搏器植入对IVNC伴心动过缓的治疗是有益的,有利于患者持续的抗心律失常药物治疗。

Objective To study the efficacy of pacemaker therapy in IVNC with bradycardia.Methods Four adults（29~52 years old） of IVNC with bradycardia were involved in our study： sinus bradycarida（n=1）,sinus arrest（n=1）,sinus bradycardia and junctional rhythm（n=1）,persistent atrial fibrillation with long ventricular pauses（n=1）.Three patients suffered from bradycardia after taking amiodarone or β-receptor blockers.All these four patients underwent pacemaker implantation,among whom three received dual-chamber pacemakers（DDD） and one received a single-chamber pacemaker（VVI）.All patients restarted the antiarrhythmia medications after the operation and were followed up for a mean period of 49 months.Results No patient suffered from bradycardia after treatment,and only ventricular ectopies were noted.One patient had persistent atrial fibrillation,which lasted for 6 months and then converted into sinus rhythm;the patient died in the 15th post-operative month without any further medication.Conclusion Pacemaker implantation is beneficial to IVNC with bradycardia.