Bilbao F J, Zabalza I E, Vilanova J R, Froufe J
Circulation. 1987 Apr;75(4):733-6. doi: 10.1161/01.cir.75.4.733.
The specialized conducting systems of 44 hearts with posterior-inferior acute myocardial infarction were studied to clarify the anatomic basis of atrioventricular (AV) block. The results showed a lack of correlation between the block and the lesional pathology of the specialized conducting system. On the other hand, an evaluation of the atrial prenodal myocardium revealed strong clinicopathologic correlation between the block and the necrotic damage to these fibers. Twenty-nine or 97% of patients with AV block showed acute necrosis of the prenodal atrial myocardium. Considering the conducting prenodal septal atrial myocardium as a suprahisian structure, the necrosis at this level would provide an anatomic basis of the block in posterior-inferior acute myocardial infarction. Analysis of the behavior of the AV block after pharmacologic treatment further established a relationship between the block and acute lesions in the central conduction system.
对44例后下壁急性心肌梗死患者的心脏特殊传导系统进行了研究，以阐明房室传导阻滞的解剖学基础。结果显示，传导阻滞与特殊传导系统的病变病理之间缺乏相关性。另一方面，对结前心房肌的评估显示，传导阻滞与这些纤维的坏死损伤之间存在很强的临床病理相关性。29例（占97%）房室传导阻滞患者出现结前心房肌急性坏死。将结前间隔心房肌视为希氏束以上结构，该水平的坏死可为后下壁急性心肌梗死的传导阻滞提供解剖学基础。药物治疗后房室传导阻滞行为的分析进一步证实了传导阻滞与中枢传导系统急性病变之间的关系。
