白喉性心肌炎合并缓慢性心律失常患者的预后：心室起搏结果评估
Prognosis in patients with diphtheric myocarditis and bradyarrhythmias: assessment of results of ventricular pacing.
作者信息
Stockins B A, Lanas F T, Saavedra J G, Opazo J A
机构信息
Department of Cardiology, School of Medicine, Universidad de la Frontera, Temuco, Chile.
出版信息
Br Heart J. 1994 Aug;72(2):190-1. doi: 10.1136/hrt.72.2.190.
OBJECTIVE
To determine the prognosis in patients with diphtherial myocarditis and bradyarrhythmias and to assess the results of ventricular pacing in those with third degree atrioventricular block.
DESIGN
Case series.
SETTING
Referral department of cardiology in a teaching hospital.
PATIENTS
Twenty four out of 46 patients admitted with diphtherial myocarditis over 10 years had bradyarrhythmias. Six had sinus bradycardia, 15 atrioventricular or intraventricular conduction disturbances, and three atrioventricular dissociation.
MAIN OUTCOME MEASURE
Death rate.
RESULTS
Eleven patients died (46%): all seven patients with third degree atrioventricular block, the patient with bifascicular block, and three of the six patients with bundle branch block. Seven died of cardiogenic shock and four of ventricular fibrillation. All nine patients with sinus bradycardia or atrioventricular dissociation survived.
CONCLUSION
Conduction system disturbances in patients with diphtherial myocarditis are markers of severe myocardial damage and a poor prognosis. In addition, ventricular pacing does not improve survival.
目的
确定白喉性心肌炎合并缓慢性心律失常患者的预后，并评估三度房室传导阻滞患者心室起搏的效果。
设计
病例系列研究。
地点
一家教学医院的心脏病转诊科室。
患者
10年间收治的46例白喉性心肌炎患者中，24例出现缓慢性心律失常。6例为窦性心动过缓，15例为房室或室内传导障碍，3例为房室分离。
主要观察指标
死亡率。
结果
11例患者死亡（46%）：所有7例三度房室传导阻滞患者、1例双分支阻滞患者以及6例束支阻滞患者中的3例。7例死于心源性休克，4例死于心室颤动。所有9例窦性心动过缓或房室分离患者均存活。
结论
白喉性心肌炎患者的传导系统障碍是严重心肌损伤和预后不良的标志。此外，心室起搏并不能提高生存率。
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