Woo K S, Norris R M
Aust N Z J Med. 1979 Aug;9(4):411-6. doi: 10.1111/j.1445-5994.1979.tb04169.x.
Fifty-two patients with myocardial infraction complicated by bundle branch block (27 RBBB and 25 LBBB) survived the hospital period (1967--1972), and were followed up to December 1976. Actuarial survival curves revealed a worse mortality up to five years (P less than 0.05) for LBBB (68%) than for RBBB (33%). All deaths occurred in the first four years. In RBBB, additional hemiblock (seven patients) did not increase the risk of heart block nor worsen the prognosis--one death in seven patients (14%) compared to eight in 20 patients with isolated RBBB (40%). The previous literature on long term survival of BBB was reviewed. Recommended treatment for BBB, a marker of severe myocardial damage, includes antiarrhythmic prophylaxis for anteroseptal infarction with RBBB, aneurysmectomy in selected subsets of patients, and possibly prevention of RBBB or its complications by treatment for reduction of infarct size during the very early phase after onset of infarction.
52例心肌梗死合并束支传导阻滞（27例右束支传导阻滞和25例左束支传导阻滞）患者度过了住院期（1967 - 1972年），并随访至1976年12月。精算生存曲线显示，左束支传导阻滞患者五年内的死亡率（68%）高于右束支传导阻滞患者（33%），差异有统计学意义（P<0.05）。所有死亡均发生在前四年。在右束支传导阻滞患者中，合并半阻滞（7例患者）并未增加心脏传导阻滞的风险，也未使预后恶化——7例患者中有1例死亡（14%），而20例单纯右束支传导阻滞患者中有8例死亡（40%）。本文回顾了以往关于束支传导阻滞长期生存情况的文献。对于作为严重心肌损伤标志的束支传导阻滞，推荐的治疗方法包括对前间隔梗死合并右束支传导阻滞患者进行抗心律失常预防，对选定亚组患者进行动脉瘤切除术，以及可能通过在梗死发作后极早期进行减少梗死面积的治疗来预防右束支传导阻滞或其并发症。
