García Rubí D, Esperanza García C, Dublan Ramírez E
Servicio de Cardiología del Hospital de Especialidades del Centro Médico Nacional del Instituto Mexicano del Seguro Social, México, D.F.
Arch Inst Cardiol Mex. 1988 May-Jun;58(3):231-5.
26 patients with bifascicular block defined as complete right bundle branch block and left anterior block diagnosed electrocardiographically according to Medrano's criteria, were studied to evaluate the indication for preoperatory pacemaker insertion due to the risk of complete A/V block, other cardiac complications were recorded carefully. 7 patients underwent a prophylactic insertion, due to associated first degree A/V block in 4 cases and in 3 cases due to symptomatic bifascicular block. No instance of complete A/V block was found in the study. The most severe complication recorded was in a patient who presented a myocardial infarction complicated with ventricular Tachycardia. The risk of complete A/V block is low and only a small group of this patients should be considered for a preoperatory pacemaker insertion due to associated risk factors.
根据梅德拉诺标准经心电图诊断为完全性右束支传导阻滞和左前分支阻滞的26例双分支阻滞患者，为评估因完全性房室传导阻滞风险而进行术前起搏器植入的指征，仔细记录了其他心脏并发症。7例患者接受了预防性植入，其中4例因伴有一度房室传导阻滞，3例因有症状性双分支阻滞。研究中未发现完全性房室传导阻滞的病例。记录到的最严重并发症发生在一名出现心肌梗死并发室性心动过速的患者身上。完全性房室传导阻滞的风险较低，只有一小部分此类患者因相关危险因素应考虑进行术前起搏器植入。
