Ritter W S, Atkins J M, Blomqvist C G, Mullins C B
Am J Cardiol. 1976 Aug;38(2):205-8. doi: 10.1016/0002-9149(76)90151-x.
Patients with acute myocardial infarction and transient complete atrioventricular (A-V) block in association with right bundle branch block and left anterior hemiblock have a high incidence rate of late sudden death presumably due to recurrent A-V block. Over a 5 year period, 18 patients demonstrated right bundle branch block and left anterior hemiblock and had transient complete block during an acute myocardial infarction and survived to hospital discharge. Of six patients who did not have permanent pacing, five died suddenly (one was lost to follow-up) with a mean survival time of 2.4 months after hospital discharge. Twelve subsequent patients received permanent demand pacemakers and had a significantly improved prognosis with a mean survival time of 18 months (P less than 0.001). Six patients were still alive at an average follow-up time of 20 months. Prophylactic permanent pacing significantly improves the prognosis after acute myocardial infarction in this select subgroup of patients.
急性心肌梗死合并短暂性完全房室传导阻滞以及右束支传导阻滞和左前分支阻滞的患者，晚期猝死发生率较高，可能是由于反复出现房室传导阻滞所致。在5年期间，18例患者在急性心肌梗死期间出现右束支传导阻滞和左前分支阻滞，并伴有短暂性完全阻滞，且存活至出院。在6例未进行永久性起搏的患者中，5例突然死亡（1例失访），出院后平均生存时间为2.4个月。随后的12例患者接受了按需永久性起搏器治疗，预后显著改善，平均生存时间为18个月（P<0.001）。6例患者在平均20个月的随访时间时仍存活。预防性永久性起搏可显著改善这一特定亚组患者急性心肌梗死后的预后。
