Zagatti G, Fiorista F, Gadaleta G, Sarpellon M, Caturelli G
G Ital Cardiol. 1978;8 Suppl 1:50-4.
During a 24-month period, 37 patients with fascicular blocks (RBB-LAH, alternating bundle-branch block, bundle-branch block with PR prolongation, RBBB-LAH with PR prolongation) were sheduled for operation. The study was undertaken to determine what effect the stress of anesthesia and operation might have on these patients, and to attempt to answer the question whether all patients with fascicular block should have demand pacemakers implanted. All these patients were in stable condition and had no history of transient complete heart block. Patients were monitored continuously intraoperatively and were followed by serial electrocardiograms to the third postoperative day. No instance of complete heart block was found. No significant problem arose both intra- and postoperatively. According to these findings, routine, prophylactic, temporary cardiac pacing in patients with fascicular blocks, before anesthesia and during operation, seems to be not necessary in the absence of cardiac symptoms.
在24个月期间,37例患有束支阻滞(右束支-左前分支阻滞、交替性束支阻滞、伴有PR间期延长的束支阻滞、伴有PR间期延长的右束支-左前分支阻滞)的患者被安排进行手术。开展这项研究是为了确定麻醉和手术应激可能对这些患者产生何种影响,并试图回答是否所有束支阻滞患者都应植入按需起搏器这一问题。所有这些患者病情稳定,且无短暂性完全性心脏传导阻滞病史。术中对患者进行持续监测,并在术后第三天进行系列心电图检查。未发现完全性心脏传导阻滞病例。术中和术后均未出现重大问题。根据这些发现,在没有心脏症状的情况下,对于束支阻滞患者在麻醉前和手术期间进行常规预防性临时心脏起搏似乎没有必要。