伪起搏器综合征(PPMS)是一级房室传导阻滞(AV)的罕见并发症,在没有植入起搏器的情况下,非常长的PR间期会导致AV不同步以及随后的血流动力学不稳定症状。本手稿的目的是描述一个独特的PPMS病例,并对该主题进行全面审查,以帮助临床医生诊断和治疗这种疾病。通过对PubMed的系统研究,谷歌学者,EBSCO,和OvidMEDLINE,并使用搜索字符串“伪起搏器综合征”和“症状性一级房室传导阻滞”,“我们确定了14篇文章,占17例PPMS,包括我们的病例报告.PPMS最常见的年龄组是中青年,平均年龄47岁。心悸是最常见的症状,并确定了PPMS的四个主要病因。如下:(1)特发性PPMS,有房室结传导受损的证据(20%的病例),(2)与可逆转的炎症原因相关的PPMS(13%)或(3)与医源性手术或介入程序相关,导致正常AV传导系统的永久性损伤(20%),and,最后,(4)与双房室结生理(DAVNP)相关的PPM作为主要发现(27%)或在快速或慢速途径消融治疗房室结折返性心动过速(AVNRT)后发生(20%)。治疗应该是患者定制的,并基于一旦确定的具体病因。然而,无AVNRT表现的DAVNP引起的PPMS的治疗尚待澄清.
Pseudo-pacemaker syndrome (PPMS) is a rare complication of first-degree atrio-ventricular (AV) block in which a very prolonged PR interval causes AV dyssynchrony and subsequent symptoms of hemodynamic instability in the absence of an implanted pacemaker. The aim of this manuscript was to describe a unique case of PPMS and to provide a comprehensive
review of the topic to help clinicians in the diagnosis and management of this condition. Through systematic research on PubMed, Google Scholar, EBSCO, and Ovid MEDLINE and using the search strings \"pseudo-pacemaker syndrome\" and \"symptomatic first-degree AV block,\" we identified 14 articles accounting for 17 cases of PPMS, including our case report. The most common age group for PPMS was middle-aged and young adults, with an average age of 47 years. Palpitations were the most common presenting symptom and four main etiologies of PPMS were identified, as follows: (1) Idiopathic PPMS with evidence of impaired conduction over the AV node (20% of cases), (2) PPMS associated with reversable inflammatory causes (13%) or (3) associated with iatrogenic surgical or interventional procedures leading to the permanent damage of the normal AV conduction system (20%), and, finally, (4) PPM related to dual AV nodal physiology (DAVNP) as a primary finding (27%) or occurring after fast or slow pathway ablation for treatment of AV nodal re-entrant tachycardia (AVNRT) (20%). Treatment should be patient-tailored and based on the specific etiology once identified. However, the treatment of PPMS due to DAVNP without AVNRT presentation is yet to be clarified.