Bergfeldt L, Vallin H, Edhag O
Br Heart J. 1984 Feb;51(2):184-8. doi: 10.1136/hrt.51.2.184.
A genetic predisposition associated with HLA B27 for developing complete heart block with or without clinical or radiological signs of associated rheumatic disease has recently been found. In this electrophysiological study of 12 patients with spontaneous complete heart block and HLA B27 associated disease, of whom eight had ankylosing spondylitis, 10 had suprahisian second or third degree atrioventricular block (eight spontaneously and two during atrial pacing at rates below 90 impulses per minute) and one infrahisian block. One patient with narrow QRS complexes during complete heart block three months earlier had normal findings. Three patients also had sinus node malfunction and six had fascicular or bundle branch block. In HLA B27 associated disease the atrioventricular block seems to be preferentially located in the atrioventricular node, although the conduction system may be widely affected. The findings in this study indicate a further cause of high degree atrioventricular block with a predominantly suprahisian location in addition to acute inferior myocardial infarction, digitalis intoxication, and "congenital" heart block.
最近发现，与HLA - B27相关的遗传易感性会导致出现完全性心脏传导阻滞，无论是否伴有相关风湿性疾病的临床或放射学征象。在这项对12例患有自发性完全性心脏传导阻滞及HLA - B27相关疾病患者的电生理研究中，其中8例患有强直性脊柱炎，10例存在希氏束以上二度或三度房室传导阻滞（8例为自发性，2例在心房起搏频率低于每分钟90次冲动时出现），1例存在希氏束以下阻滞。1例在三个月前完全性心脏传导阻滞时QRS波群狭窄的患者检查结果正常。3例患者还存在窦房结功能障碍，6例存在分支或束支传导阻滞。在HLA - B27相关疾病中，房室传导阻滞似乎优先发生在房室结，尽管传导系统可能受到广泛影响。本研究结果表明，除急性下壁心肌梗死、洋地黄中毒和“先天性”心脏传导阻滞外，高度房室传导阻滞且主要位于希氏束以上还有另一个原因。
