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The Bradycardia-Tachycardia SyndromeTreatment with Cardiac Drugs and Adrenal Corticosteroid

机译:心脏药物和肾上腺皮质激素治疗心动过缓-心动过速综合征

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Seven patients of S-A block complicated by tachycardic paroxysms of atrial fibrillation or flutter were described and the medical treatment in this syndrome was reappraised. Damage to S-A node and adjacent atrial tissue was assumed in all patients. All the patients had syncopal attacks associated with cardiac arrest occurring especially at the termination of tachycardia. Overdrive suppression of diseased S-A node and lower automatic pacemakers was demonstrated by ECG recordings. The term "bradycardia-tachycardia syndrome" or "syndrome of alternating bradycardia and tachycardia" seemed appropriate.In spite of difficulty of medical treatment reiterated by previous descriptions, 6 of 7 patients were improved with drug therapy, including adrenal corticosteroid. Adrenal corticosteroid in combination with orciprenaline or belladonna alkaloids was most helpful among the drugs used. Obviously, pacemaker implantation should be performed without delay in patients with frequent and prolonged attacks of syncope. But not all patients have need of pacemaker implantation. A trial of drug therapy may be permitted in many patients of this syndrome before introduction of pacemaker.
机译:描述了7例S-A阻滞并发房颤或扑动的心动过速性发作,并重新评估了该综合征的药物治疗。所有患者均假定S-A淋巴结和邻近的心房组织受损。所有患者均发生与心脏骤停相关的晕厥发作,尤其是在心动过速终止时。心电图记录证明了对患病S-A节点和较低的自动起搏器的超速抑制。术语“心动过缓-心动过速综合征”或“心动过缓-心动过速综合症”似乎是适当的。尽管先前的描述重申了药物治疗的难度,但7例患者中有6例通过药物治疗得到了改善,包括肾上腺皮质类固醇。在所用药物中,肾上腺皮质类固醇与奥西肾上腺素或颠茄生物碱的组合最有用。显然,对于频发性和长期发作性晕厥的患者,应立即进行起搏器植入。但并非所有患者都需要植入起搏器。在引入心脏起搏器之前,可能会对该综合征的许多患者进行药物治疗试验。

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