Dhingra R C, Denes P, Wu D, Wyndham C R, Amat-y-Leon F, Towne W D, Rosen K M
Circulation. 1976 Apr;53(4):600-4. doi: 10.1161/01.cir.53.4.600.
Eighteen of 388 patients with chronic bundle branch block, studied electrophysiologically and followed prospectively, had H-V intervals of 80 msec or greater. Five patients were functional class I, five class II, seven class III, and one class IV. Follow-up ranged from 103 to 1919 days (mean 711 +/- 118). Three patients needed permanent pacing for the following indications: sino-atrial block, sinus bradycardia post-cardiac surgery, and 2 degrees block distal to the His bundle. Six patients died, three suddenly, and three nonsudden. The five initially asymptomatic patients are alive and without pacemakers (mean follow-up 732 +/- 139 days). Although marked H-V prolongation was associated with high morbidity and mortality in this small series, this was only in patients with symptomatic heart disease. Asymptomatic patients (five patients) had a benign clinical course. Prophylactic pacing would probably not modify clinical course in the former group, and is probably not indicated in the latter group. Longer follow-up will be needed for definitive prognostication.
388例慢性束支传导阻滞患者接受了电生理研究并进行了前瞻性随访，其中18例H-V间期达80毫秒或更长。5例为心功能I级，5例为II级，7例为III级，1例为IV级。随访时间为103至1919天（平均711±118天）。3例患者因以下指征需要永久起搏：窦房阻滞、心脏手术后窦性心动过缓以及希氏束远端二度阻滞。6例患者死亡，3例猝死，3例非猝死。5例最初无症状的患者存活且未安装起搏器（平均随访732±139天）。尽管在这个小系列研究中，显著的H-V间期延长与高发病率和死亡率相关，但这仅见于有症状性心脏病的患者。无症状患者（5例）临床病程良性。预防性起搏可能无法改变前一组患者的临床病程，而后一组患者可能不需要预防性起搏。需要更长时间的随访以进行明确的预后评估。
