engleski

Natural history of infra-His atrioventricular block induced by atrial pacing in symptomatic patients with chronic bundle branch block

Natural history of infra-His AV block induced by atrial pacing was prospectively investigated in patients (Pts) with chronic BBB and syncope, comparing 204 Pts with normal response to atrial pacing (Group I), and 18 Pts with infra-His induced AV block (Group II). Pts in Group I had higher incidence of organic heart disease (p<0-01), congestive heart failure (p<0.05) and VT tachycardia induction (p<0.05). Pts in group II had higher incidence of primary conduction disease (p<0.001) and prolonged H-V intervals (p<0.001). During a men follow-up period of 65+-34 months, a development of high degree AV block was higher in Group II, than in Group I (78% versus 7%, p<0.001) The site of AV block was infranodal in all Pts in Group II. and in 10 of 15 Pts in greoup I. Because of prophylactic pacing in all Pts in Group II, the incidence of sudden death was similar among the two groups. but Pts in Group I had higher incidence of cardiac death (p<0.05). Conclusion: In Pts with chronic BBB and syncope, infra-His AV block induced by atrial pacing identified Pts with high risk os AV block development. Therefore, these Pts had an absolute indication for prophylactic permanent pacing.

infra-His AV block; atrial pacing

nije evidentirano