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A case of Pickwickian syndrome treated by implantation of a cardiac permanent pacemaker Nagao Ogata 1 , Haruyuki Takatori 1 , Juro Kamijima 1 , Koichiro Tatsumi 2,3 , Takayuki Kuriyama 3 1Division of Cardiology, Odawara City Hospital 2Division of Respiratory disease, Odawara City Hospital 3Department of Chest Medicine, Institute of Pulmonary Cancer Research, School of Medicine, Chiba University pp.791-795
Published Date 1989/7/15
DOI https://doi.org/10.11477/mf.1404205514
  • Abstract
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A 41-year-old male was admitted to our hospital with congestive heart failure and bronchopneumo-nia. During hospitalization extreme sinus brady-cardia, sinus arrest up to 6. 2 seconds and high grade AV block were observed to occur simultaneously with apneic episodes of ECG monitoring. After that, a diagnosis of Pickwickian syndrome was made in this obese patient. In spite of weight reduction, change of sleep position and acetazolamide admini-stration, obstructive sleep apnea and severe bradyar-rhythmias were not improve.

These severe bradyarrhythmias and ventricular tachyarrhythmias may be one cause of the not in-frequent sudden deaths in patients with this Pick-wickian syndrome.

In addition to the tracheostomy, we propose that implantation of a cardiac permanent pacemaker should be selected for the bradyarrhythmias in association with the Pickwickian syndrome.


Copyright © 1989, Igaku-Shoin Ltd. All rights reserved.

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