Alpert M A, Curtis J J, Sanfelippo J F, Flaker G C, Walls J T, Mukerji V, Villarreal D, Katti S K, Madigan N P, Krol R B
J Am Coll Cardiol. 1986 Apr;7(4):925-32. doi: 10.1016/s0735-1097(86)80358-8.
To determine whether survival after permanent ventricular demand (VVI) pacing differs from survival after permanent dual chamber (DVI or DDD) pacing in patients with chronic high degree atrioventricular (AV) block (Mobitz type II or trifascicular block), 132 patients who received a VVI pacemaker (Group 1) and 48 patients who received a DVI or DDD pacemaker (Group 2) were followed up for 1 to 5 years. There was no significant difference in sex distribution, mean age or incidence of coronary heart disease, hypertension, valvular heart disease, diabetes mellitus, stroke or renal failure between Groups 1 and 2. Overall, the predicted cumulative survival rate at 1, 3 and 5 years was 89, 76 and 73%, respectively, for Group 1 and 95, 82 and 70%, respectively, for Group 2. In patients with preexistent congestive heart failure, the predicted cumulative survival rate at 1, 3 and 5 years was 85, 66 and 47%, respectively, for Group 1 (n = 53) and 94, 81 and 69%, respectively, for Group 2 (n = 20). The 5 year predicted cumulative survival rate was significantly lower in Group 1 patients with preexistent congestive heart failure than in Group 2 patients with the same condition (p less than 0.02). There was no significant difference in 5 year cumulative survival rate between Groups 1 and 2 for patients without preexistent congestive heart failure. The results suggest that permanent dual chamber pacing enhances survival to a greater extent than does permanent ventricular demand pacing in patients with high degree AV block and preexistent congestive heart failure.
为了确定慢性高度房室传导阻滞（莫氏Ⅱ型或三分支阻滞）患者接受永久性心室按需起搏（VVI）后的生存率是否与接受永久性双腔起搏（DVI或DDD）后的生存率不同，对132例接受VVI起搏器的患者（第1组）和48例接受DVI或DDD起搏器的患者（第2组）进行了1至5年的随访。第1组和第2组在性别分布、平均年龄或冠心病、高血压、瓣膜性心脏病、糖尿病、中风或肾衰竭的发生率方面无显著差异。总体而言，第1组1年、3年和5年的预测累积生存率分别为89%、76%和73%，第2组分别为95%、82%和70%。在已有充血性心力衰竭的患者中，第1组（n = 53）1年、3年和5年的预测累积生存率分别为85%、66%和47%，第2组（n = 20）分别为94%、81%和69%。已有充血性心力衰竭的第1组患者的5年预测累积生存率显著低于相同病情的第2组患者（p < 0.02）。对于无充血性心力衰竭病史的患者，第1组和第2组的5年累积生存率无显著差异。结果表明，在高度房室传导阻滞且已有充血性心力衰竭的患者中，永久性双腔起搏比永久性心室按需起搏能更大程度地提高生存率。
