永久性起搏器植入术后高度房室传导阻滞的自然病程。

Natural history of high-grade atrioventricular block following permanent pacemaker implantation.

作者信息

Alpert M A, Katti S K

出版信息

J Chronic Dis. 1982;35(5):341-9. doi: 10.1016/0021-9681(82)90005-4.

Abstract

We followed 120 patients 4-14 yr after permanent pacemaker implantation for high-grade atrioventricular block to assess the effect of sex, age at implantation, date of implantation and various chronic co-existent illnesses on survival. The overall survival rates were 91% at 1 yr, 63% at 5 yr and 41% at 10 yr. Patients with congestive heart failure demonstrated the lowest survival rates of all cohorts studied. Survival rates of patients with congestive heart failure were significantly lower than survival rates of patients without congestive heart failure and were also significantly lower than those of patients with conduction system disease only. Similarly, patients with coronary heart disease demonstrated significantly lower survival rates than both patients without coronary heart disease and patients with conduction system disease only. The presence of hypertension, valvular heart disease, diabetes mellitus or cerebral infarction influenced survival less adversely than congestive heart failure or coronary heart disease. Survival decreased progressively with increasing age; however, the differences were not significant. Sex and date of implantation had no apparent effect on survival. Thus, coronary heart disease and the presence of congestive heart failure appear to be the major determinants of survival following permanent pacemaker implantation for high-grade atrioventricular block.

摘要

我们对120例因高度房室传导阻滞植入永久性起搏器的患者进行了4至14年的随访，以评估性别、植入时年龄、植入日期以及各种慢性并存疾病对生存率的影响。1年时的总生存率为91%，5年时为63%，10年时为41%。充血性心力衰竭患者在所有研究队列中的生存率最低。充血性心力衰竭患者的生存率显著低于无充血性心力衰竭的患者，也显著低于仅患有传导系统疾病的患者。同样，冠心病患者的生存率显著低于无冠心病的患者以及仅患有传导系统疾病的患者。高血压、瓣膜性心脏病、糖尿病或脑梗死的存在对生存率的不利影响小于充血性心力衰竭或冠心病。生存率随年龄增长而逐渐下降；然而，差异并不显著。性别和植入日期对生存率没有明显影响。因此，冠心病和充血性心力衰竭的存在似乎是高度房室传导阻滞植入永久性起搏器后生存的主要决定因素。