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作者报告1例高度房室传导阻滞并伴有高血压的78岁男性患者,在准备安置起搏器前,为降压而选用了对传导系统影响最小的钙拮抗剂nicardipine 60mg/d。于用药的第4天,心率由38增至50/min,大部分为室性心律。为了判定本药的疗效而停药观察,停药的第6天又出现房室传导阻滞,心率降至30/min。再次用药后第10天心率又增至50～60/min,当药量增加至120mg/d,3天后房室传导阻滞完全消失。用药前作希氏束电图,当心房起搏的刺激频率为70/min时,出现2∶1传导阻滞。用药后心房起搏的频率>120/min才出现2∶1传导。用药前作马氏二级阶梯试验时出现房室传导阻滞,用药后心率升至
The authors report a 78-year-old man with a high degree of atrioventricular block and hypertension with nicardipine 60mg / d, a calcium-antagonist that minimizes the conduction system for blood pressure lowering before setting up his pacemaker. On the fourth day of treatment, the heart rate increased from 38 to 50 / min, mostly ventricular rhythm. In order to determine the efficacy of the drug withdrawal observation, withdrawal of the first 6 days of atrioventricular block, the heart rate dropped to 30 / min. On the 10th day after treatment, the heart rate increased to 50-60 / min. When the dose increased to 120 mg / d, the AV block disappeared completely after 3 days. Histidine beam before treatment, when the atrial pacing stimulation frequency of 70 / min, there 2: 1 block. After administration of atrial pacing frequency> 120 / min appeared 2: 1 conduction. Before treatment for Markov two ladder test occurs when atrioventricular block, heart rate rose to after treatment