Objective To investigate the clinical characteristics of a Chinese pedigree with cardiac conductive disease complicated by atrial fibrillation and the therapeutic effect of the treatments. Methods All the family members including the proband were screened with routine examination, electrocardiography, echocardiograpy, Holter recording, chest X-ray, blood biochemistry tests and autoanribody test. The proband received dual chamber pacemaker implantation combined with oral amiodarone treatment for 3 months. The patient was monitored for thyreoid function and chest X-ray during the treatments, and was followed up for another 3 months. Results Clinical evidence of organic heart disease was found in none of the family members. The proband showed recurrent dizziness and chest distress, which exacerbated after exercise, and ECG showed atrial fibrillation and severe A-V block. The proband's uncle was found to have atrial fibrillation and III degree A-V block after a syncope episode at the age of 30, and received a pacemaker treatment. Her grandpa died from a heart attack without detailed clinical documentations. No other family members showed abnormal ECG or a history of any heart events. The proband's condition was improved by treatments, after which ECG and Holter recording showed pace rhythm without atrial fibrillation. Conclusion Cardiac conductive disease with atrial fibrillation can present in one family, and can be managed effectively and safely with implantation of dual chamber pacemaker combined with oral amiodarone.%目的 探讨一个家族性心脏传导疾病并房颤家系的临床特征及其有效的治疗方案.方法 对先证患者所在家系的家族成员进行常规临床体检和心电图、超声心动图、动态心电图、X线胸片、生化、自身抗体等检查.同时对先证者行双腔起搏器安置术联合口服胺碘酮治疗3个月,期间监测患者甲功及肺部情况,治疗完成后随访3个月,并对相关文献进行回顾.结果 家系中所有成员均无器质性心脏病的临床证据.先证者反复头晕、胸闷,以活动后较明显,静息心电图表现为心房纤颤伴高度房室传导阻滞；其叔叔于30岁时因晕厥发现“心房纤颤,三度房室传导阻滞”而安置起搏器治疗；其爷爷死于“心脏病”(具体不详)；其他家族成员心电图检查未见明显异常,既往亦未发生明显的心脏事件(晕厥、猝死).患者经治疗后症状明显好转,心电图及动态心电图均未见心房纤颤,起搏器工作良好.结论 心脏传导性疾病并心房纤颤可呈家族聚集性发病,双腔起搏器联合胺碘酮治疗可作为家族性心脏传导疾病并心房纤颤患者安全有效的治疗措施.
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