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患者男性,64岁。因诊断为鼻咽癌侵犯颅底收入肿瘤科,拟作放射治疗。入院后出现心动过缓,多次发生昏厥。于入院后第5天转来心内科,经心电监护及阿托品试验确诊为病态窦房结综合征合并阿-斯综合征,安装 VVI 埋藏式起搏器,安装时用起搏器分析仪测试起搏有关参数,均属正常范围。心腔内心电图呈 rS 型,ST段呈单向抬高曲线,心肌阻抗500Ω,起搏阈值为1.4V。术后第2天起,有间歇性起搏不良,至术后第5天虽有起搏信号,但全部不起搏。X 线胸片未发现电极移位,考虑可能为起搏阈值升高所致,用地塞米松20mg+5％葡萄糖500ml静脉点滴1次/天,第2天即见部分能起搏,至第5天地塞米松增至30mg/天,第6天开始起
Patient male, 64 years old. Due to diagnosis of nasal pharyngeal cancer invaders skull base revenue, intended to make radiation therapy. After admission, bradycardia, multiple syncope occurred. On the 5th day after admission, he was referred to Department of Cardiology, diagnosed as sick Sinus Syndrome with Asperger’s Syndrome by ECG and A-Si syndrome, installed with VVI buried pacemaker and installed with pacemaker analyzer Pace-related parameters are within the normal range. Intracardiac electrocardiogram showed rS type, ST segment showed a one-way elevation curve, myocardial impedance 500Ω, pacing threshold of 1.4V. From the second day after operation, there was intermittent pacing failure. Although the pacing signal was on the 5th postoperative day, all of them did not pacing. X-ray showed no electrode shift, consider the possibility of increased pacing threshold due to dexamethasone 20mg +5% glucose 500ml intravenous drip 1 day / day, that part of the second day that can be pacing to 5 Dexamethasone to 30mg / day, the first 6 days