直立倾斜试验诱发迷走神经性房颤1例报告

Head-up tilt test induced vagal atrial fibrillation:a case report

目的探讨直立倾斜试验中诱发出阵发性心房颤动的原因。方法回顾分析1例在直立倾斜试验中诱发出迷走神经性房颤的血管迷走性晕厥患儿的临床资料,同时复习相关文献。结果患儿,女,7岁,1年内晕厥2次。患儿无阳性体征。血常规、血生化检查均无异常,脑电图、头颅CT、心电图、心脏彩色多普勒超声检查结果均无异常。患儿在直立倾斜试验中出现5.3s窦性静止,继而发生房室连接处逸搏心律、房性早搏、心房颤动。患儿经健康教育和自主神经功能锻炼治疗,半年后随访,未出现晕厥,未发生心房颤动。结论直立倾斜试验中迷走神经张力增高可诱发迷走神经性房颤。

Objective To explore the cause of atrial fibrillation during the head-up tilt test(HUTT).Method The data of a child with vasovagal syncope in whom atrial fibrillation was induced in HUTT was analyzed retrospectively,and the related literatures were reviewed.Result A 7-year-old girl was admitted with a history of 2 episodes of loss of consciousness last year.Each episode lasted for 2 minutes.There were no unusual neurological findings,and the blood chemistry results were all normal.Electrocardiogram and echocardiography did not reveal any abnormalities.Electroencephalogram,CT scans of the brain were normal.During the HUTT,40 minutes after the start of tilting,the child felt nausea and chest tightness with pale face,at that time her blood pressure and heart rate were 87/49 mmHg and 50 beats/min.During lying down,the girl’s ECG showed sinus arrest of 5.3 seconds followed with escape rhythm of atrioventricular junction,atrial premature,atrial fibrillation.After half a year’s health education and autonomic nerve function training,there was no syncope or atrial fibrillation.Conclusion Increased vagal tone may induce atrial fibrillation during the head-up tilt test.