Baumann P C
Schweiz Med Wochenschr. 1976 Mar 20;106(12):406-11.
In addition to the widely accepted criteria for the implantation of a permanent pacemaker (bradyarrhythmias combined with syncope, cardiac decompensation, angina pectoris etc.) ther are borderline situations where the decision for a pacemaker is less easy: 1) marked bradycardia with only minor symptoms, 2) syncope without appropriate electrocardiographic abnormality, 3) bifascicular blocks, 4) tachyarrhythmias refractory to medical therapy. In connection with these situations, 3 syndromes are discussed with particular reference to the indication for pacemaker: A) hyperactive carotid sinus reflex syndrome, B) sick sinus syndrome, C) fascicular block. A pacemaker is a fairly safe method of therapy (although with some complications) which should not only be used as a last resort (e.g. in severe Adams-Stokes syndrome) but in patients whose condition may improve after a pacemaker implantation or be prevented from getting worse. Patients with pacemakers have a mean survival rate of 80-90% after 1 year and of 50-60% after 5 years.
除了植入永久性起搏器的广泛认可标准（缓慢性心律失常合并晕厥、心脏失代偿、心绞痛等）外，还有一些临界情况，在此种情况下决定是否植入起搏器并不那么容易：1）显著心动过缓但仅有轻微症状；2）晕厥但无相应心电图异常；3）双分支阻滞；4）药物治疗无效的快速性心律失常。针对这些情况，特别参照起搏器适应证讨论了3种综合征：A）颈动脉窦反射亢进综合征；B）病态窦房结综合征；C）分支阻滞。起搏器是一种相当安全的治疗方法（尽管有一些并发症），它不应仅作为最后手段使用（例如在严重的阿-斯综合征中），而应应用于那些植入起搏器后病情可能改善或防止病情恶化的患者。植入起搏器的患者1年后平均生存率为80%-90%，5年后为50%-60%。
