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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Paroxysmal AV block in children with normal cardiac anatomy as a cause of syncope.
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Paroxysmal AV block in children with normal cardiac anatomy as a cause of syncope.

机译：心脏解剖正常的儿童阵发性房室传导阻滞是晕厥的原因。

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BACKGROUND: Syncope due to episodes of paroxysmal atrioventricular (AV) block, defined as transient advanced second or third-degree block, is rarely reported in pediatric patients without congenital heart disease. METHODS: We reviewed our institutional arrhythmia database from January 1988 to January 2007 to identify all patients less than 18 years of age with normal cardiac anatomy and episodes of syncope associated with paroxysmal AV block. Demographic and clinical information was collected. RESULTS: Six patients were identified (Table I). Five of the six patients were female, with an average age of 9.3 +/- 4.4 years. Patients had episodes of syncope for an average of 5.6 +/- 3.3 years prior to diagnosis. All patients had normal physical examinations, electrocardiograms, and echocardiograms. None were on medications known to interfere with AV nodal function, and laboratory evaluation including Lyme titers were negative. Five of the six patients' episodes were atypical for vasovagal syncope (except patient 6). All patients had documented paroxysmal AV block on either inpatient cardiac monitor, Holter monitor, or event recorder at the time of syncope. There was maintenance or acceleration of the sinus rate during episodes of syncope in all patients (mean atrial rate 107 +/- 37 bpm). All six patients had permanent transvenous pacemakers implanted with resolution of symptoms over a mean follow-up of 5.2 +/- 6.3 years. CONCLUSION: Paroxysmal AV nodal block is a rare finding in pediatric patients, but should be considered as a possible etiology in patients presenting with episodes atypical for vasovagal syncope. Pacemaker therapy prevented future episodes in all six of our patients.
机译：背景：在没有先天性心脏病的小儿患者中，很少报道由于阵发性房室传导阻滞（AV）的发作而引起的晕厥，定义为暂时性的晚期二级或三级传导阻滞。方法：我们回顾了1988年1月至2007年1月的机构性心律失常数据库，以识别所有18岁以下且心脏解剖结构正常且晕厥与阵发性AV阻滞相关的患者。收集了人口统计学和临床​​信息。结果：确定了六名患者（表一）。六个患者中有五个是女性，平均年龄为9.3 +/- 4.4岁。诊断前患者出现晕厥发作的平均时间为5.6 +/- 3.3年。所有患者的体格检查，心电图和超声心动图正常。没有人使用已知会干扰房室结功能的药物，包括莱姆滴度在内的实验室评估均为阴性。六个患者发作中有五个非典型的血管迷走性晕厥（患者6除外）。在晕厥时，所有患者均在住院心脏监护仪，Holter监护仪或事件记录仪上记录了阵发性房室传导阻滞。在所有患者的晕厥发作期间，窦率维持或加速（平均心房率107 +/- 37 bpm）。所有6例患者均接受了永久性静脉起搏器植入，平均随访5.2 +/- 6.3年，症状得以缓解。结论：阵发性AV结阻滞在儿科患者中很少见，但对于表现为非典型血管迷走性晕厥发作的患者，应将其视为可能的病因。起搏器疗法可防止我们所有六名患者的未来发作。

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