杨伟,刘宏,陈章荣,吴新华,段显凤

• 1:大理大学第一附属医院心内科

摘要(Abstract)：

<正>1临床资料患者女,31岁。因"反复活动后心悸1年余,加重2 d"入住大理大学第一附属医院。1年来反复活动后心悸,持续10 min左右休息后自行缓解。2 d来上述心悸发作频繁,2019年1月3日就诊于大理大学第一附属医院心内科门诊。心电图示:阵发性室上性心动过速。遂收住入院拟行射频消融术。既往无特殊病史。入院查体:呼吸166次/分,血压122/76 mm Hg(1 mm Hg=0.133 k Pa),心率166次/分,律齐,各瓣膜听诊区未闻及病理性杂音及心包摩擦音。发作时心电图示:阵发性室上性心动过速(图1),恢复窦性心律后心电图见图2。血常规、肝肾功能、电解质、甲状腺功能未见异常。超声心动图、X线胸片未见明显异常。无手术禁忌证并签署手术知情同意书。

关键词(KeyWords)： 伊伐布雷定;不适当窦性心动过速;房室结折返性心动过速

Abstract:

Keywords:

基金项目(Foundation): 云南省教育厅科研项目(2019J0766)

作者(Author): 杨伟,刘宏,陈章荣,吴新华,段显凤

参考文献(References)：

• [1]Ruzieh M,Moustafa A,Sabbagh E,et al.Challenges in treatment of inappropriate sinus tachycardia.Curr Cardiol Rev,2018,14(1):42-44.
• [2]Skeberis V,Simonis F,Tsakonas K,et al.Inappropriate sinus tachycardia f ollowing radiof requency ablation of AV nodal tachycardia:incidence and clinical signif icance.Pacing Clin Electrophysiol,1994,17(5 Pt 1):924-927.
• [3]伊伐布雷定，慢性心力衰竭治疗新希望.中国介入心脏病学杂志，2015,23(9):537.
• [4]Vaillant F,Lauzier B,Ruiz M,et al.Ivabradine and metoprolol differentially affect cardiac glucose metabolism despite similar heart rate reduction in a mouse model of dyslipidemia.Am J Physiol Heart Circ Physiol,2016,311(4):H991-H1003.
• [5]Barzilai M,Jacob G.The effect of ivabradine on the heart rate and sympathovagal balance in postural tachycardia syndrome patients.Rambam Maimonides Med J,2015,6(3):e0028.
• [6]Annamaria M,Lupo PP,Foresti S,et al.Treatment of inappropriate sinus tachycardia with ivabradine.J Interv Card Electrophysiol,2016,46(1):47-53.
• [7]Sheldon RS,Grubb BP II,Olshansky B,et al.2015 heart rhythm societ y ex per t consensus sta temen t on t he diagnosis a nd treatment of postural tachycardia syndrome,inappropriate sinus tachycardia,and vasovagal syncope.Heart Rhythm,2015,12(6):e41-e63.
• [8]Ptaszynski P,Kaczmarek K,Ruta J,et al.Ivabradine in the treatment of inappropriate sinus tachycardia in patients af ter successful radiofrequency catheter ablation of atrioventricular node slow pathway.Pacing Clin Electrophysiol,2013,36(1):42-49.