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患者,女性,58岁,退休工人,两年前因患冠心病,Ⅲ度房室传导阻滞(AVB)、心室率为30～40次/分,常有头晕和晕厥;心电图示Ⅲ度AVB、交界性逸搏心律。安装秦明公司产按需起搏器。术后自觉症状消失,心率稳定在72次/分,一般情况较好。近期常感气短、乏力、全身不适等症状,来院要求检测起搏器功能。检查前,常规心电图均为起搏心电图,无自主心律,为观察自主心律需做胸壁刺激试验。我们采用泰州产的FD—1型调搏仪,设S_1S_2档,电压为7伏,脉宽为10毫伏,频率为80次/分进行刺激试验。由于误把刺激信号当作自主心律,致使调搏刺激试验持续9.2秒(见附图)致病人突然出现头晕、眼黑、神志丧失、抽搐等阿-斯综合征的表现。立即终止试验,病人症状很快消失,观察一天,无任何不良反应,起搏功能正常。
58 years old, retired workers, two years ago due to coronary heart disease, Ⅲ degree atrioventricular block (AVB), ventricular rate of 30 to 40 beats / min, often dizziness and syncope; ECG shows third degree AVB , Borderline escape rhythm. Qin company to produce on-demand pacemaker. After the symptoms disappeared, heart rate stabilized at 72 beats / min, the general situation is better. Recently often feel shortness of breath, fatigue, malaise and other symptoms, to the hospital to test the pacemaker function. Before the examination, the conventional ECG were pacing ECG, no independent heart rhythm, chest wall stimulation test for the observation of autonomic rhythm. We use Taizhou FD-1-type pacemaker, set S_1S_2 file, the voltage is 7 volts, the pulse width of 10 millivolts, the frequency of 80 beats / min stimulation test. As a result of mistaking the stimulus signal as an autonomous rhythm, resulting in pacing stimulus test continued 9.2 seconds (see photo) caused sudden onset of the patient dizziness, black eyes, loss of consciousness, convulsions and other As-Syndrome performance. Immediate termination of the trial, the patient symptoms disappeared quickly, observe the day, without any adverse reactions, pacing normal.