Hofschire P J, Nicoloff D M, Moller J H
Am J Cardiol. 1977 Apr;39(4):559-62. doi: 10.1016/s0002-9149(77)80166-5.
Between 1957 and 1973, a total of 64 children had complete heart block during intracardiac surgery were treated by one of three methods: (1) No pacemaker: Six of the 13 patients in this group had reversion to sinus rhythm. Seven patients continued to have complete heart block, and five of these died of Stokes-Adams episodes. Two patients continue to have complete heart block without pacemaker insertion. (2) Temporary pacemaker: Seventeen of 25 patients had reversion to sinus rhythm and the temporary pacemaker was removed; the other 8 continued to have complete heart block. Five of the eight died--three of Stokes-Adams episodes and two at the time of cardiac reoperation. Three remain asymptomatic without placement of a permanent pacemaker. Six died of postoperative complications unrelated to heart block or pacemaker implantation. None of the other 20 experienced Stokes-Adams attacks. There was one late death in this group. Although there are problems in using permanent pacemakers and electrode systems, in these patients with operatively induced complete heart block their use was associated with a low mortality rate.
1957年至1973年间，共有64名在心脏内手术期间出现完全性心脏传导阻滞的儿童接受了以下三种方法之一的治疗：（1）未使用起搏器：该组13名患者中有6名恢复窦性心律。7名患者持续存在完全性心脏传导阻滞，其中5名死于斯托克斯-亚当斯发作。2名患者未植入起搏器，仍持续存在完全性心脏传导阻滞。（2）临时起搏器：25名患者中有17名恢复窦性心律，临时起搏器被移除；另外8名患者持续存在完全性心脏传导阻滞。这8名患者中有5名死亡——3名死于斯托克斯-亚当斯发作，2名死于心脏再次手术时。3名患者未植入永久性起搏器，仍无症状。6名患者死于与心脏传导阻滞或起搏器植入无关的术后并发症。该组其他20名患者均未发生斯托克斯-亚当斯发作。该组有1例晚期死亡。尽管使用永久性起搏器和电极系统存在问题，但在这些因手术导致完全性心脏传导阻滞的患者中，其使用与低死亡率相关。
