Ginks W R, Sutton R, Oh W, Leatham A
Br Heart J. 1977 Feb;39(2):186-9. doi: 10.1136/hrt.39.2.186.
The purpose of this study was to evaluate the need for permanent pacing in patients who have survived the effects of anterior myocardial infarction with complete heart block and have returned to sinus rhythm but who are left with impairment of intraventricular conduction. We have reviewed 52 patients with complete heart block complicating recent anterior myocardial infarction. Temporary pacing was instituted in all patients. There were 25 hospital survivors who were followed for an average of 49 months. Long-term pacing was established in 4 patients. Of the 21 patients in sinus rhythm, 14 had partial bilateral bundle-branch block with either right bundle-branch block and left anterior hemiblock or right bundle-branch block and left posterior hemiblock; at the end of the follow-up period, 10 of these 14 were alive and well. Furthermore, permanent pacing failed to prevent sudden death in 2 patients. At the present time, therefore, we conclude that long-term pacing is not justified in patients, otherwise asymptomatic, with partial bilateral bundle-branch block persisting after transient complete heart block in anterior myocardial infarction.
本研究的目的是评估前壁心肌梗死合并完全性心脏传导阻滞且已恢复窦性心律但仍存在室内传导障碍的患者是否需要永久性起搏治疗。我们回顾了52例近期前壁心肌梗死合并完全性心脏传导阻滞的患者。所有患者均接受了临时起搏治疗。有25例患者存活出院，平均随访49个月。4例患者接受了长期起搏治疗。在21例恢复窦性心律的患者中，14例存在不完全性双侧束支传导阻滞，表现为右束支传导阻滞合并左前分支阻滞或右束支传导阻滞合并左后分支阻滞；随访期末，这14例患者中有10例存活且情况良好。此外，2例患者尽管接受了永久性起搏治疗仍发生了猝死。因此，目前我们得出结论，对于前壁心肌梗死短暂性完全性心脏传导阻滞恢复后仍存在不完全性双侧束支传导阻滞但无其他症状的患者，长期起搏治疗并无必要。
