Pine M B, Oren M, Ciafone R, Rosner B, Hirota Y, Rabinowitz B, Abelmann W H
J Am Coll Cardiol. 1983 May;1(5):1207-12. doi: 10.1016/s0735-1097(83)80131-4.
Excess mortality and morbidity associated with right bundle branch and left anterior fascicular block were evaluated in 108 patients with block (age 74 +/- 10 years, 69% male) and 108 age- and sex-matched control patients with normal conduction. Clinical characteristics were similar initially except for more congestive heart failure in patients with block. Life table analysis revealed a higher 12 year mortality with block, even after omitting patients with moderate or severe congestive heart failure (risk ratio 1.47, p less than 0.05). Compared with control subjects, the group of patients with block had more sudden death and deaths of unknown cause, but a similar number of noncardiac and diagnosed cardiac deaths. More patients with block developed new second and third degree atrioventricular block or new overt coronary artery disease, but this finding did not support prophylactic pacing in asymptomatic patients. The importance of internal controls in assessing the natural history of clinical and electrocardiographic abnormalities is emphasized.
对108例存在右束支传导阻滞和左前分支阻滞的患者（年龄74±10岁，69%为男性）以及108例年龄和性别匹配、传导正常的对照患者，评估了与上述阻滞相关的额外死亡率和发病率。除阻滞患者中充血性心力衰竭更多见外，两组患者最初的临床特征相似。生存表分析显示，即使排除中度或重度充血性心力衰竭患者，阻滞患者12年死亡率仍较高（风险比1.47，p<0.05）。与对照组相比，阻滞患者组猝死和不明原因死亡更多，但非心脏性死亡和已确诊的心脏性死亡数量相似。更多阻滞患者出现新的二度和三度房室传导阻滞或新的明显冠状动脉疾病，但这一发现并不支持对无症状患者进行预防性起搏。强调了内部对照在评估临床和心电图异常自然史中的重要性。
