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患者女,78岁,因高血压病史10多年,胸闷、呼吸困难2个月,ECG示较长PR间期(0.46s)入院,彩色多普勒超声:心脏各腔室不大,左室舒张径35mm,经二尖瓣多普勒血流示:E峰和A峰融合,舒张期二尖瓣返流明显,冠状动脉造影检查正常。给患者安装DDD型心脏永久起搏器,调整适当AV间期后,临床心力衰竭症状明显改善。结论:对较长PR间期I度房室阻滞、且伴心力衰竭的患者,安装DDD型心脏永久起搏器,似可给患者带来明显的血流动力学益处。
The patient was female, aged 78, with a history of hypertension over 10 years, tightness of the chest and difficulty breathing for 2 months. ECG showed a longer PR interval (0.46 s) for admission. Color Doppler ultrasound was not found in all chambers of the heart and left ventricular diastolic Diameter 35mm, the mitral Doppler blood flow showed: E peak and A peak fusion, diastolic mitral regurgitation, coronary angiography was normal. To patients with DDD permanent heart pacemakers installed, adjust the appropriate AV interval, the clinical symptoms of heart failure improved significantly. CONCLUSIONS: For DD patients with long-term PR interval I degree atrioventricular block and heart failure, DDD-type permanent cardiac pacemakers may appear to deliver significant hemodynamic benefits to patients.