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患者男,51岁,患冠心病.心房纤颤已5年.1989年始间断口服维拉帕米(40mg,tid),1992年3月以来.未再服用维拉帕米.也未用β-受体阻滞剂及洋地黄制剂.1993年元月10日晨觉心悸.自扪心跳达140次/min.上午7时20分自行顿服维拉帕米120mg,8时左右觉头昏、黑矇、心悸.胸闷加剧,无昏厥及四肢抽搐.8时50分急诊入院.体检:BP 8.0/6.7kPa(60/50mm Hg),四肢厥冷,双肺底无罗音.心率47次/min,律齐.立即行心电监测,示三度房室传寻阻滞(Ⅲ°AVB).无ST—T改变.给予阿托品静注.多巴胺、阿拉明静滴.9时30分血压升为16.0/10.OkPa;10点时Ⅲ°AVB消失.心室率70～90次/min,为房颤律.且有室早、短阵室速.遂给予利多卡因50mg静注.继而lmg/min静滴维持.下午1时30分恢复为窦性心律,继续监测24h.均为窦性心律.病情稳定1周后出院.
Male, 51 years old with coronary heart disease, atrial fibrillation for 5 years, discontinued oral verapamil (40 mg, tid) since 1989. Verapamil has not been taken since March 1992. Beta-glucan Receptor blockers and digitalis preparations January 1993 morning palpitations heart palpitations. Since the heart up to 140 beats / min. At 7:20 on their own vetiver verapamil 120mg, about 8 pm feel dizzy, Dark, palpitations .Expression of chest tightness, no fainting and limbs twitch .8: 50 emergency admission .Patients: BP 8.0 / 6.7kPa (60 / 50mmHg), extremities Jueleng, min, law Qi. Immediate ECG monitoring, showed the third atrioventricular block (Ⅲ ° AVB). No ST-T changes. Give atropine intravenous injection of dopamine, Alaramine .9: 30 blood pressure or Was 16.0 / 10.OkPa; 10 ° when the disappearance of Ⅲ ° AVB. Ventricular rate of 70 to 90 beats / min, atrial fibrillation law and room early, short-term ventricular tachycardia was given lidocaine 50mg intravenous. Then lmg / min intravenously to maintain .At 1:30 pm to return to sinus rhythm, continue to monitor 24h .All sinus rhythm.A stable condition after 1 week was discharged.