Venkataraman K, Madias J E, Hood W B
Chest. 1975 Oct;68(4):501-6. doi: 10.1378/chest.68.4.501.
To determine the need for prophylactic temporary pacing in bifascicular block during surgical and other procedures, a retrospective analysis was carrried out in 38 patients who underwent a total of 74 procedures. The male:female sex ratio was 3.2:1 and mean age was 74 (range 48-96) years. Known organic heart disease was absent in 45 percent of the total group. Patients were divided into four groups on the basis of their preoperative electrocardiograms. Of the 74 procedures, 19 were carried out under general, 22 under spinal and 29 under regional anesthesia; four endoscopic procedures were done without anesthesia. There was only one complication relating to deterioration of AV conduction. It is concluded that asymptomatic patients with right bundle branch block and left anterior hemiblock do not require prophylactic preoperative pacemaker insertion. Though experience is limited, the same may be true of patients with the additional finding of prolongation of PR interval.
为了确定在手术及其他操作过程中双分支阻滞患者是否需要预防性临时起搏，对38例患者进行了回顾性分析，这些患者共接受了74次手术。男女比例为3.2:1，平均年龄为74岁（范围48 - 96岁）。45%的患者无已知器质性心脏病。根据术前心电图将患者分为四组。在74次手术中，19次在全身麻醉下进行，22次在脊髓麻醉下进行，29次在区域麻醉下进行；4次内镜手术未使用麻醉。仅发生1例与房室传导恶化相关的并发症。结论是，无症状的右束支阻滞和左前分支阻滞患者术前无需预防性植入起搏器。尽管经验有限，但PR间期延长的患者可能也是如此。
