ペースメーカー植込みを余儀なくされた後天性房室ブロックの1学童例

A school boy with acquired A-V block who required a permanent pacemaker implantation

　1960年代の後半より房室ブロックを有する小児に対してのpacemaker植込みの報告が多数なされている^1〜26）が，その大半は先天性および開心術後の症例である。本稿では，Adams-Stokes発作を起こした後天性房室ブロックで，pacemaker植込みを施行した学童の心電図経過および心腔内心電図所見について報告する。

A school boy with acquired A-V block who re-quired a permanent pacemaker implantation at 8 year old was reported. His electrocadiogram taken at 5 year old showed normal. He had an episode of high fever for 4 days and a rash appeared on his skin at 5 year old.

One year later, his electrocardiogram revealed CRBBB. Two years later, it developed an advanc-ed A-V block progressively and he had complained of dizziness and early fatigue. He admitted to Yokohama City University Hospital at 8 year old because of cardiovascular evaluation. His bundle electrogram showed that his bundle potential was low, AH interval was 78 msec with 2 : 1 conduc-tion, and HV interval was 59 msec. Maximal ven-tricular recovery time was 1730 msec.

In view of the results of electrophysiological ex-aminations, it was concluded that there was no indication of pacemaker implantation. However, he required a permanent pacemaker implantation because of several episodes of Adams-Stokes attack, and has since been asymptomatic.