Sumiyoshi M, Nakata Y, Yasuda M, Tokano T, Ohno Y, Ogura S, Nakazato Y, Yamaguchi H
Department of Cardiology, Juntendo University School of Medicine Tokyo, Japan.
Jpn Circ J. 1995 May;59(5):284-91. doi: 10.1253/jcj.59.284.
The purpose of this study was to examine the long-term course of conductivity in patients with second- or third-degree atrioventricular (AV) block after pacemaker implantation. Fifty-four patients (30 males and 24 females, mean age 59.5 years) had a 12-lead electrocardiogram (ECG) recorded prior to pacemaker implantation and again after a follow-up of more than 5 years (mean 108 months). The degree of AV block and the morphology of the QRS complex in the two ECGs were compared. Twenty-eight (85%) of the 33 patients with complete AV block and 15 (71%) of the 21 patients with second-degree AV block before implantation showed complete AV block after the follow-up period. The progression of AV block was recognized only in patients with intra-His (BH) or infra-His (H-V) block. In 29 patients, escape QRS complexes were recorded in both ECGs. A change in the QRS complex was noted in 6 patients (21%), including 2 with new bundle branch block (BBB), 2 with wider BBB, 1 with new left axis deviation, and 1 with a change to another BBB. This change was particularly notable in the H-V block group (44%).
(1) Most patients with complete AV block did not recover AV conductivity after the long-term follow-up. (2) Second-degree BH and H-V block tended to progress to complete AV block.
