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患者男性 ,5 8岁 ,18年前因病窦综合征行VVI起搏器置入 ,后因电极脱位而自成AAI起搏 ,于 1年前更换起搏器时 ,心房电极因阻抗过高 ,再次置入心房电极不能起搏而改为VVI起搏 ,术后出现起搏器综合征。经电生理检查 ,证实右房上部无A波 ,冠状窦口可记录到A波 ,并可行心房起搏。右室起搏时为室房 1∶1逆传 ,此为起搏器综合征的机制。故保留原右室电极 ,于冠状窦口加心房螺旋电极固定 ,DDD起搏成功 ,起搏器综合征消失。
Male patient, aged 58 years and 18 years ago, had a VVI pacemaker insertion due to sick sinus syndrome and then became AAI pacing due to dislocation of the electrode. When the pacemaker was changed a year ago, the atrial electrode became too high impedance , Again into the atrial electrode can not be replaced by pacemaker and VVI pacing, pacemaker syndrome after surgery. The electrophysiological examination confirmed that there was no A wave in the upper part of the right atrium. A coronary sinus ostium could record A wave and could atrial pacing. Right ventricular pacing for the room 1: 1 reverse, this is the mechanism of pacemaker syndrome. Therefore, retain the original right ventricular electrode in the coronary sinus plus atrial spiral electrode fixation, DDD pacing success, pacemaker syndrome disappeared.