3例右冠状动脉痉挛致Ⅲ度房室传导阻滞临床分析

目的：强调右冠状动脉痉挛可引起Ⅲ度房室传导阻滞。方法：3例间歇性Ⅲ度房室传导阻滞患者于发作时经12导联和（或）动脉心电图记录到ST段上台。冠状造影和麦角新碱激发试验证实右冠状动脉痉挛的存在。患者均接受硫氮唑酮为主的药物治疗，对冠脉严重病变的1例行PTCA及支架置入。结果：分别随访4－12月，症状改善，未发生黑Meng、晕厥。结论：冠状动脉痉挛可诱发严重的心律失常，钙拮抗剂治疗有效。

Right Coronary Spasm as a Cause of Three-Degree Atrioventricular Block

Objective:To emphasize that ri ght coronary spasm can cause three-degree AVB.Methods:Three patients were recor de d by 12-leads ECG and(or)Holter as having ST segment elevation and proceding thr ee-degree AVB.Coronary angiography and ergonovine test comfirmed right artery sp asm.All three received drug therapy mainly diltizem,while the one with severe un derlying atherosclerotic lesions was performed PTCA and stents implantation.Resu lts:Symptoms have improved with no attacks of syncope in the follow up period of 4～12 months.Conclusions:Coronary spasm can provoke lethal arrhythmia,but be tr eated effectively with Calcium Channel Blocker.