発声により誘発された上室性頻脈症の1例

概要

論文の詳細を見る
ElectrophysioJogic studies were performed on a 54-year-old man with speech-induced supraventricular tachycardia. Speaking almost always provoked repetitive atrial tachycardias with rate of 100 beats/min to 200 beats/min, which were usually separated by one or a few sinus beats. Intracardiac electrocardiograms revealed no prolongation of P-R interval and warm up phase on initiation of tachycardia. Sinus node recovery time was normal by overdrive suppression test. Atrial extrastimulus technique was unable to demonstrate the presence of AV nodal dual pathways and this could induced neither tachycardia nor atrial echoes. The effective refractory period of the atrium and the AV node was normal. These findings suggested an ectopic rapidly firing automatic atrial pacemaker or micro-reentry within several adjacent cells within the atrium caused by vagovagal reflexes, as the mechanism of the speech-induced tachycardia in this case. Tha tachycardia was well controled by the combined therapy of digoxin and procainamide or digoxin and disopyramide.
神戸大学の論文