Carrasco H A, Mora R, Inglessis G, Contreras J M, Marval J, Fuenmayor A
Arch Inst Cardiol Mex. 1982 May-Jun;52(3):245-51.
In order to detect possible abnormalities in sinus node function and atrio-ventricular conduction, one hundred and fourty three chagasic patients were subjected to electrophysiologic and pharmacologic studies. These patients were placed in four categories based on the their clinical, hemodynamic and angiographic characteristics. The chagasic patient without cardiac involvement (group IA), had no detectable abnormalities. Ten percent of those patients with early myocardial damage (group IB), had impaired sinus node automaticity. In three percent, the autonomic innervation was also altered and four percent had abnormally prolonged atrio-ventricular conduction. Among chagasic patients with abnormal EKG'S without heart failure (Group II), 45% had impaired sinus node automaticity, autonomic innervation was altered in 12%, and atrio-ventricular conduction was prolonged in 37%. Sinus node automaticity was impaired in 22% of those patients with abnormal EKG'S and heart failure (Group III). Autonomic innervation was altered in 33%, and atrio-ventricular conduction was prolonged in 47%. We conclude that over half of our patients with abnormal EKG'S will eventually require permanent pacing. Therefore, in these chagasic patients sinus node function and atrioventricular conduction should be routinely studied.
为了检测窦房结功能和房室传导可能存在的异常，对143例恰加斯病患者进行了电生理和药理学研究。根据这些患者的临床、血流动力学和血管造影特征，将他们分为四类。无心脏受累的恰加斯病患者（IA组）未检测到异常。早期心肌损伤患者（IB组）中有10%的患者窦房结自律性受损。3%的患者自主神经支配也发生改变，4%的患者房室传导异常延长。在心电图异常但无心力衰竭的恰加斯病患者（II组）中，45%的患者窦房结自律性受损，12%的患者自主神经支配改变，37%的患者房室传导延长。心电图异常且有心力衰竭的患者（III组）中有22%的患者窦房结自律性受损。33%的患者自主神经支配改变，47%的患者房室传导延长。我们得出结论，超过一半的心电图异常患者最终将需要永久起搏。因此，对于这些恰加斯病患者，应常规研究窦房结功能和房室传导。
