AHブロックから完全房室ブロックに移行した血液透析患者の1例

Abstract

We report a 71-year-old woman on maintenance hemodialysis who progres- sed from AH block to complete heart block. She had been dialyzed for chronic renal failure due to diabetic nephropathy during the preceding 17months. She was admitted to our hospital because of 2 : 1 AV (atrioventricular) block, but had neither syncope nor dizziness. On admission, ECG showed second-degree AV block (Wenckebach type), cardiac electro- physiological studies showed first-degree AH block (AH interval was 280 msec), and echocardiogram showed mitral annular calcification. On the 20 th hospital day, the patient suffered an Adams-Stokes attack, and ECG showed complete heart block. A permanent pacemaker was implanted. This was a rare case in which a patient on maintenance hemodialysis progressed from AH block to complete heart block in 20 days, probably due to mitral annular calcification.