Forsberg S A, Juul-Möller S
Acta Med Scand. 1979;206(6):483-7. doi: 10.1111/j.0954-6820.1979.tb13551.x.
A number of 597 patients with acute myocardial infarction (AMI) were treated with continuous ECG monitoring of the heart rhythm in a coronary care unit for at least three days. We found 84 patients with heart block, 39 with complete, 29 with at most second degree and 16 with at most first degree heart block. The treatment was primarily conservative; 22 of the 39 patients with complete heart block were given isoproterenol and two received temporary pacemakers. Survival was traced over two years in the whole patient group with myocardial infarctions. Heart block implied a worsened prognosis over the two years, but survival was independent of the degree of heart block. Among those with complete heart block, survival did not differ from that of a comparable patient series from Copenhagen, where all patients were given pacemakers. This does not support indiscriminate artificial pacing of patients with AMI and complete heart block. Our results ought to be controlled in a randomized study.
597例急性心肌梗死（AMI）患者在冠心病监护病房接受了至少三天的心律连续心电图监测。我们发现84例患者存在心脏传导阻滞，其中39例为完全性，29例为最多二度，16例为最多一度心脏传导阻滞。治疗主要是保守治疗；39例完全性心脏传导阻滞患者中有22例给予了异丙肾上腺素，2例接受了临时起搏器治疗。对整个心肌梗死患者组进行了两年的生存追踪。心脏传导阻滞意味着两年内预后恶化，但生存率与心脏传导阻滞程度无关。在完全性心脏传导阻滞患者中，生存率与哥本哈根一组类似患者系列并无差异，在该系列中所有患者均接受了起搏器治疗。这并不支持对AMI和完全性心脏传导阻滞患者进行无差别人工起搏。我们的结果应在一项随机研究中加以验证。
