Ivabradine in the treatment of non-paroxysmal junctional tachycardia with interference atrioventricular dissociation: A case report

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Annals of Noninvasive Electrocardiology Pub Date : 2023-05-08 DOI:10.1111/anec.13064

Shuo Ying Master of Medicine, Jing Zhang Doctor of Medicine, Nai-kuan Fu Master of Medicine, Peng Zhang Doctor of Medicine

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Abstract

Ivabradine reduces the heart rate by selectively inhibiting the I_f current of the sinoatrial node, mainly for the treatment of chronic heart failure with decreased left ventricular systolic function and inappropriate sinus tachycardia, but the inhibitory effect on the atrioventricular node is rarely reported. The patient was admitted to hospital mainly because of intermittent chest pain for 7 years, which worsened for 10 days. Admission electrocardiogram (ECG) considered sinus tachycardia, with QS wave and T wave inversion in II, III, aVF, V₃R-V₅R, V₄–V₉ leads, and non-paroxysmal junctional tachycardia (NPJT) with interference atrioventricular dissociation. After treatment with ivabradine the ECG returned to normal conduction sequence. NPJT with interference atrioventricular dissociation is a fairly rare electrocardiographic phenomenon. This case reports for the first time that ivabradine is used in the treatment of NPJT with interference atrioventricular dissociation. It is speculated that ivabradine has a potential inhibitory effect on the atrioventricular node.

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伊伐布雷定治疗非阵发性结性心动过速伴房室分离1例

伊伐布雷定通过选择性抑制窦房结If电流降低心率，主要用于慢性心力衰竭伴左室收缩功能下降和不适当窦性心动过速的治疗，但对房室结的抑制作用鲜有报道。患者主要因间歇性胸痛住院7年，病情加重10天。入院时心电图考虑窦性心动过速，II、III、aVF、V3R-V5R、V4-V9导联出现QS波和T波反转，非阵发性结性心动过速(NPJT)伴有干扰性房室分离。经伊伐布雷定治疗后，心电图恢复正常传导序列。NPJT合并干扰房室分离是一种相当罕见的心电图现象。本病例首次报道伊伐布雷定用于治疗伴有干扰性房室分离的NPJT。推测伊伐布雷定对房室结有潜在的抑制作用。

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来源期刊

Annals of Noninvasive Electrocardiology 医学-心血管系统

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The ANNALS OF NONINVASIVE ELECTROCARDIOLOGY (A.N.E) is an online only journal that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. ANE is the first journal in an evolving subspecialty that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. The publication includes topics related to 12-lead, exercise and high-resolution electrocardiography, arrhythmias, ischemia, repolarization phenomena, heart rate variability, circadian rhythms, bioengineering technology, signal-averaged ECGs, T-wave alternans and automatic external defibrillation. ANE publishes peer-reviewed articles of interest to clinicians and researchers in the field of noninvasive electrocardiology. Original research, clinical studies, state-of-the-art reviews, case reports, technical notes, and letters to the editors will be published to meet future demands in this field.