三度房室传导阻滞

紧急程度中等
常见中度严重

它是一种慢性心律失常,其特征在于心脏腔之间的电传导的完全中断。心房和心室之间存在电气断开。

有可逆和不可逆转的原因;超过一半的病例与先前梗塞引起的心肌纤维化有关,这会影响心脏电传导系统。最常见的可逆原因是药物和血液中离子浓度的变化(主要是钾)。

它可以没有症状,但通常会导致疲劳,头晕,呼吸短促,胸痛,意识丧失和心脏骤停。

它通过临床病史,体格检查和心电图诊断。

治疗将取决于症状的严重程度,生命体征,对初始治疗的反应以及潜在可逆性原因的鉴定。在最严重的情况下,药物可用于加速心率或植入瞬时起搏器。放置永久起搏器后,它将完全解决。

参考文献
  1. William H Sauer. Third degree (complete) atrioventricular block. UpToDate. Aug 10, 2015.
  2. Neumar RW, Otto CW, Link MS, et al. Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2010; 122:S729.
  3. Curtis AB, Worley SJ, Adamson PB, et al. Biventricular pacing for atrioventricular block and systolic dysfunction. N Engl J Med 2013; 368:1585.
  4. Takaya Y, Kusano KF, Nakamura K, Ito H. Outcomes in patients with high-degree atrioventricular block as the initial manifestation of cardiac sarcoidosis. Am J Cardiol 2015; 115:505.
  5. Epstein AE, DiMarco JP, Ellenbogen KA, et al. ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. Circulation 2008; 117:e350.
  6. Sonia Bartolomé Mateos, Eduardo Castellanos Martínez, José Aguilar Florit. Manejo de las arritmias en Urgencias. Manual de protocolos y actuación en urgencias. Hospital Virgen de la Salud, Complejo Hospitalario de Toledo. Tercera edición. 2010. 243:250.
  7. David D. Spragg, Gordon F. Tomaselli. Bradiarritmias; Trastornos del nódulo auriculoventricular. Harrison. Principios de Medicina Interna. Volumen 2. 19º Edición. 1470:1476.
作者
医生 Elvira Moreno
版权
© TeckelMedical 2026

症状

    失去意识


    心动过缓


    很少小便


    头晕


    因窒息而将头抬高睡觉