Edhag O, Bergfeldt L, Edvardsson N, Holmberg S, Rosenqvist M, Vallin H
Br Heart J. 1984 Oct;52(4):408-12. doi: 10.1136/hrt.52.4.408.
Eleven patients with bifascicular block complicating anteroseptal acute myocardial infarction were studied to determine the effect of prophylactic permanent pacing; eight of them also had transient high grade atrioventricular block during the acute phase of the infarction. One month after the infarction an electrophysiological study was performed and a bradycardia indicating pacemaker implanted. All the patients were followed for two years. Six had bradycardia detected, two of whom did not have high grade atrioventricular block during the index infarction. Seven patients died, four of them suddenly. There was no correlation between the electrophysiological findings and subsequent development of bradycardia. Thus pacemaker dependence seems to be common in patients with bifascicular block complicating acute myocardial infarction. Mortality is, however, also high in patients treated with pacemakers. Prospective studies to determine the predictive factors in those patients with an anterior acute myocardial infarction and who benefit from a combination of permanent pacemaker treatment and antiarrhythmic treatment are needed.
对11例合并前间壁急性心肌梗死的双分支阻滞患者进行了研究，以确定预防性永久起搏的效果；其中8例在梗死急性期还出现了短暂的高度房室传导阻滞。梗死1个月后进行了电生理研究，并植入了指示起搏器的心动过缓装置。所有患者均随访了两年。6例检测到心动过缓，其中2例在首次梗死期间未出现高度房室传导阻滞。7例患者死亡，其中4例猝死。电生理检查结果与随后发生的心动过缓之间无相关性。因此，起搏器依赖在合并急性心肌梗死的双分支阻滞患者中似乎很常见。然而，接受起搏器治疗的患者死亡率也很高。需要进行前瞻性研究，以确定那些前壁急性心肌梗死患者中可预测的因素，以及哪些患者能从永久起搏器治疗和抗心律失常治疗的联合应用中获益。
