The Bradycardia-Tachycardia Syndrome:Treatment with Cardiac Drugs and Adrenal Corticosteroid

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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.
International Heart Journal刊行会の論文