Hetzel M R, Ginks W R, Pickersgill A J, Leatham A
Br Heart J. 1978 Aug;40(8):864-9. doi: 10.1136/hrt.40.8.864.
The effect of permanent pacing on chronic complete atrioventricular block complicated by cardiac failure was studied in 6 patients by measurement of indirect left atrial pressure 15 minutes after institution of pacing and again 3 to 12 months later. In addition, 21 patients with complete heart block and clinical plus radiological evidence of cardiac failure at the time of pacing 3 to 6 years earlier were also reviewed. Only 1 of 6 patients studied haemodynamically improved and 1 died in cardiac failure. Of 21 patients assessed clinically, 10 had improved and 8 had died after a mean follow-up of 53 months. In the absence of syncope, pacing was of little symptomatic benefit but still may be justified to prolong survival. Both studies indicated a particularly poor prognosis for patients known to have coronary artery disease. No reliable means were found of determining the prognosis in the individual patient with cardiac failure before pacing.
通过测量6例慢性完全性房室传导阻滞合并心力衰竭患者起搏开始后15分钟及3至12个月后的间接左房压力，研究了永久性起搏的效果。此外，还回顾了另外21例3至6年前起搏时患有完全性心脏传导阻滞且有临床及放射学心力衰竭证据的患者。在接受血流动力学研究的6例患者中，只有1例血流动力学得到改善，1例死于心力衰竭。在接受临床评估的21例患者中，平均随访53个月后，10例病情改善，8例死亡。在无晕厥的情况下，起搏对症状改善作用不大，但仍可能对延长生存期有意义。两项研究均表明，已知患有冠状动脉疾病的患者预后特别差。在起搏前，未找到确定心力衰竭个体患者预后的可靠方法。
