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.