Click R L, Gersh B J, Sugrue D D, Holmes D R, Wood D L, Osborn M J, Hammill S C
Am J Cardiol. 1987 Apr 1;59(8):817-23. doi: 10.1016/0002-9149(87)91098-8.
Electrophysiologic testing was performed in 112 symptomatic patients with bundle branch block. Abnormalities included HV interval 70 ms or longer (35 patients), infra-Hisian block with atrial pacing (6 patients) and sinus node dysfunction (23 patients). Inducible ventricular tachycardia occurred in 47 patients (42%). Therapy was based on the electrophysiologic test result: group I--16 patients with no therapy (normal study results); group II--34 patients with permanent pacing alone; group III--39 patients with antiarrhythmic therapy alone; and group IV--21 patients with both antiarrhythmic therapy and permanent pacing. Cumulative 4-year survival rates were 83% in group I, 84% in group II, 63% in group III and 84% in group IV (mean follow-up 2.5 years). Recurrent syncope occurred in 19% of group I, 6% of group II, 33% of group III and 19% of group IV. In symptomatic patients with bundle branch block and normal electrophysiologic test results, prognosis is good without treatment. In patients undergoing permanent pacing based on electrophysiologic testing, survival is good and rate of symptom recurrence is low. Electrophysiologic testing identifies patients with inducible ventricular tachycardia for whom antiarrhythmic therapy is indicated but who nevertheless have a poor prognosis.
对112例有症状的束支传导阻滞患者进行了电生理检查。异常情况包括HV间期70毫秒或更长（35例患者）、心房起搏时希氏束下阻滞（6例患者）和窦房结功能障碍（23例患者）。47例患者（42%）诱发出室性心动过速。治疗基于电生理检查结果：第一组——16例未接受治疗的患者（检查结果正常）；第二组——34例仅接受永久起搏治疗的患者；第三组——39例仅接受抗心律失常治疗的患者；第四组——21例同时接受抗心律失常治疗和永久起搏的患者。4年累积生存率在第一组为83%，第二组为84%，第三组为63%，第四组为84%（平均随访2.5年）。第一组19%的患者、第二组6%的患者、第三组33%的患者和第四组19%的患者出现反复晕厥。在有症状的束支传导阻滞且电生理检查结果正常的患者中，未经治疗预后良好。在基于电生理检查接受永久起搏治疗的患者中，生存率良好且症状复发率较低。电生理检查可识别出适合接受抗心律失常治疗但预后较差的诱发出室性心动过速的患者。
