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起搏器联合伊布利特治疗儿童慢-快综合征1例并文献复习

Pacemaker Combined with Ibutilide in the Treatment of a Child with Bradycardia-Tachycardia Syndrome and Literature Review

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【作者】 周挥茗; 李运泉; 巴宏军; 李轩狄; 王慧深; 覃有振;

【Author】 Zhou Huiming;Li Yunquan;Ba Hongjun;Li Xuandi;Wang Huishen;Qin Youzhen;The First Affiliated Hospital, Sun Yat-sen University;

【通讯作者】 覃有振;

【机构】 中山大学附属第一医院;

【摘要】 目的:分析1例双腔永久起搏器(DDD起搏模式)联合伊布利特治疗儿童慢-快综合征的病例,探讨伊布利特在儿童应用的有效性和安全性。方法:诊治1例儿童慢-快综合征,结合病例特点与文献资料,总结分析起搏器联合伊布利特治疗儿童慢-快综合征的有效性和安全性。结果:置入起搏器后,患儿的心动过缓得以纠正,存在房内折返性心动过速、QT-c间期延长。伊布利特使患儿房内折返性心动过速消失,但QT-c间期进一步延长。伊布利特继续支持治疗1个月后,房内折返性心动过速复现,QT-c间期明显缩短;3个月后,房内折返性心动过速仍存在,但QT-c间期已缩短至正常范围。结论:双腔永久起搏器(DDD起搏模式)是治疗儿童病态窦房结综合征的有效手段,伊布利特对长期性儿童慢-快综合征的快速性心律失常有短期抑制作用。伊布利特治疗后长期支持治疗和随访非常重要。

【Abstract】 Objective: To analyze the efficacy of dual-chamber permanent pacemaker(DDD pacing mode) combined with ibutilide in the treatment of a child with bradycardia-tachycardia syndrome, and explore the application availability and security of ibutilide in children. Methods: The efficacy and safety of pacemaker combined with ibutilide in the treatment of a child with bradycardia-tachycardia syndrome were summarized and analyzed based on the characteristics of the case and literature. Results: After pacemaker implantation, the bradycardia of the child was corrected, and there was intra atrial reentrant tachycardia and prolonged QT-c interval. Ibutilide resulted in the disappearance of intra atrial reentrant tachycardia in the child, but the QT-c interval was further prolonged. After one month of continued supportive therapy with ibutilide, the intra atrial reentrant tachycardia recurred and QT-c interval was significantly shortened. After three months, there was still some intra atrial reentrant tachycardia, yet the QT-c interval had been shortened to the normal range. Conclusion: Dual-Chamber permanent pacemaker(DDD pacing mode) is an effective method for the treatment of sick sinus syndrome in children. Ibutilide has the short-term inhibitory effect on the tachyarrhythmia of bradycardia-tachycardia syndrome in children. Long-Term supportive treatment and follow-up after ibutilide treatment is essential.

【基金】 教育部博士点—博导基金,编号20130171110048
  • 【文献出处】 儿科药学杂志 ,Journal of Pediatric Pharmacy , 编辑部邮箱 ,2021年06期
  • 【分类号】R725.4
  • 【被引频次】1
  • 【下载频次】62
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