Postexercise Cardiac Asystole

ZHAO Yuntao

doi:null

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Postexercise Cardiac Asystole

Special Feature | 更新时间：2026-01-06

- Postexercise Cardiac Asystole
- J Clin Electrocardiol Vol. 34, Issue 6, Pages: 401-405(2025)
- 作者机构：
  
  100049 北京，北京大学航天中心医院心脏医学部
- 作者简介：
- 基金信息：
- DOI：
  CLC： R541.7;R540.4+1
- Received：05 November 2025，
  
  Accepted：21 November 2025，
  
  Published：28 December 2025
- 稿件说明：
移动端阅览
赵运涛. 平板运动试验诱发的血管迷走性晕厥[J]. 临床心电学杂志, 2025, 34(6): 401-405.

.Postexercise Cardiac Asystole ZHAO Yuntao. Department of Cardiology, Peking University Aerospace Center Hospital. Beijing 100049 ,China[J].J Clin Electrocardiol,2025,34(06):401-405.
赵运涛. 平板运动试验诱发的血管迷走性晕厥[J]. 临床心电学杂志, 2025, 34(6): 401-405. DOI：

.Postexercise Cardiac Asystole ZHAO Yuntao. Department of Cardiology, Peking University Aerospace Center Hospital. Beijing 100049 ,China[J].J Clin Electrocardiol,2025,34(06):401-405. DOI：

摘要

47岁男性患者，既往高血压病史，平素血压控制良好。平板运动试验恢复期6分钟出现晕厥前兆，心电图示窦性心动过缓伴交界性逸搏及房室分离，休息后症状自行恢复。心脏超声与冠脉CTA排除结构性心脏病。诊断为运动诱发血管迷走性晕厥。其机制为运动后静脉回流骤降、交感神经活性迅速下降及迷走神经过度激活，引发Bezold–Jarisch反射，导致窦房结抑制。平板运动试验可动态评估自主神经反应，有助于识别运动后反射性晕厥。治疗以避免诱因及行为干预为主，药物疗效有限，仅复发或严重窦性停搏者考虑起搏器，预后良好。

Abstract

A 47-year-old male with well-controlled hypertension developed presyncope six minutes into the recovery phase of a treadmill exercise test. Electrocardiography demonstrated sinus bradycardia with junctional escape rhythm and atrioventricular dissociation

which resolved spontaneously after rest. Echocardiography and coronary computed tomography angiography excluded structural or ischemic heart disease. The diagnosis of exercise-induced vasovagal syncope was established. The episode was attributed to a sudden reduction in venous return

rapid sympathetic withdrawal

and excessive vagal activation during recovery

triggering the Bezold–Jarisch reflex and resulting in transient sinus node suppression. Treadmill testing provides valuable dynamic evaluation of autonomic modulation and facilitates identification of reflex-mediated syncope occurring after exercise. Management should emphasize trigger avoidance and behavioral modification

while pharmacologic therapy offers limited benefit. Pacemaker implantation may be considered only in recurrent or severe cases with documented sinus arrest. The overall prognosis is favorable.

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references

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