Rosenheck S, Bondy C, Weiss A T, Gotsman M S
Cardiology Unit, Hadassah Mount Scopus University Hospital, Jerusalem, Israel.
Pacing Clin Electrophysiol. 1993 Feb;16(2):272-6. doi: 10.1111/j.1540-8159.1993.tb01576.x.
The underlying heart rhythm was evaluated in 74 patients with complete atrioventricular block and had a permanent pacemaker implantation. The pacing was inhibited for 10 seconds or until the patient developed symptoms of presyncope or syncope. Fifty-six patients (74%) had a reliable escape with a mean cycle length of 2010 +/- 596 msec and a mean escape interval of 2335 +/- 971 msec. In 93% of these patients the escape interval was < 4 seconds. The patients without reliable escape (24%), developed symptoms only after a mean of 7153 +/- 1875 msec. The duration of the conduction disorder was longer in the patients without escape and the intraventricular conduction was slower. More patients without escape were treated and antiarrhythmic agents. Forty-eight patients were followed for 1 year and underwent at least two different studies and 13% had different results at different tests. In conclusion, patients without reliable escape have a longer history of conduction disorder, a slower intraventricular conduction, and are frequently treated with antiarrhythmic agents. Even patients with reliable escape occasionally may show a greater pacemaker dependence; therefore, they should also be considered as pacemaker dependent.
对74例患有完全性房室传导阻滞并植入永久性起搏器的患者的潜在心律进行了评估。起搏被抑制10秒或直至患者出现先兆晕厥或晕厥症状。56例患者（74%）有可靠的逸搏，平均周期长度为2010±596毫秒，平均逸搏间期为2335±971毫秒。在这些患者中，93%的逸搏间期<4秒。没有可靠逸搏的患者（24%），平均在7153±1875毫秒后出现症状。没有逸搏的患者传导障碍持续时间更长，室内传导更慢。更多没有逸搏的患者接受了抗心律失常药物治疗。48例患者随访1年，至少进行了两项不同的检查，13%的患者在不同检查中有不同结果。总之，没有可靠逸搏的患者传导障碍病史更长，室内传导更慢，且经常接受抗心律失常药物治疗。即使有可靠逸搏的患者偶尔也可能表现出更大的起搏器依赖性；因此，他们也应被视为起搏器依赖患者。
