Adachi Masamitsu, Igawa Osamu, Yano Akio, Miake Junichiro, Inoue Yoshiaki, Ogura Kazuyoshi, Kato Masaru, Iitsuka Kazuhiko, Hisatome Ichiro
Department of Cardiovascular Medicine, Tottori University Hospital, 36-1 Nishimachi, Yonago 683-8504, Japan.
Europace. 2008 Feb;10(2):134-7. doi: 10.1093/europace/eum290. Epub 2008 Jan 16.
To compare the risk of atrioventricular (AV) conduction disturbance between patients with sinus node dysfunction on AAI pacing who had a low or high Wenckebach block rate (WBR).
Patients with sinus node dysfunction and normal AV conduction those underwent an electrophysiological study were studied. The patients were classified into two groups: Group L was with the patients with a WBR of 100 to 129 per minute and Group H was with the patients with a WBR > or = 130 per minute. All patients followed up every 3-6 months after an AAI pacemaker implantation. A total of 102 patients, including 35 Group L and 67 Group H, were followed for 90 +/- 44 months. Six patients died from non-cardiac cause and five patients required a new atrial lead implantation due to lead failure during follow-up. Symptomatic bradycardia requiring a new ventricular lead implantation developed in four patients (annual incidence 0.5%). In Group L, two patients developed AV block (annual incidence 0.7%). In Group H, two patients developed bradycardic atrial fibrillation (annual incidence 0.4%). Kaplan-Meier analysis revealed no significant difference between the two groups (P = 0.2983).
These results suggest that a long-term risk of developing AV conduction disturbance is low even in patients with a WBR of 100 to 129 per minute.
比较在AAI起搏治疗的窦房结功能障碍患者中，Wenckebach阻滞率（WBR）低或高的患者发生房室传导障碍的风险。
对接受电生理研究的窦房结功能障碍且房室传导正常的患者进行研究。患者被分为两组：L组为WBR为每分钟100至129次的患者，H组为WBR≥130次/分钟的患者。所有患者在植入AAI起搏器后每3至6个月进行一次随访。共有102例患者，包括35例L组患者和67例H组患者，随访90±44个月。6例患者死于非心脏原因，5例患者因随访期间导线故障需要植入新的心房导线。4例患者出现需要植入新的心室导线的症状性心动过缓（年发生率0.5%）。L组有2例患者发生房室传导阻滞（年发生率0.7%）。H组有2例患者发生缓慢性心房颤动（年发生率0.4%）。Kaplan-Meier分析显示两组之间无显著差异（P = 0.2983）。
这些结果表明，即使是WBR为每分钟100至129次的患者，发生房室传导障碍的长期风险也较低。
