Prospective observations in patients with chronic bundle branch block and marked H-V prolongation.

Abstract:

:Eighteen of 388 patients with chronic bundle branch block, studied electrophysiologically and followed prospectively, had H-V intervals of 80 msec or greater. Five patients were functional class I, five class II, seven class III, and one class IV. Follow-up ranged from 103 to 1919 days (mean 711 +/- 118). Three patients needed permanent pacing for the following indications: sino-atrial block, sinus bradycardia post-cardiac surgery, and 2 degrees block distal to the His bundle. Six patients died, three suddenly, and three nonsudden. The five initially asymptomatic patients are alive and without pacemakers (mean follow-up 732 +/- 139 days). Although marked H-V prolongation was associated with high morbidity and mortality in this small series, this was only in patients with symptomatic heart disease. Asymptomatic patients (five patients) had a benign clinical course. Prophylactic pacing would probably not modify clinical course in the former group, and is probably not indicated in the latter group. Longer follow-up will be needed for definitive prognostication.

journal_name

Circulation

journal_title

Circulation

authors

Dhingra RC,Denes P,Wu D,Wyndham CR,Amat-y-Leon F,Towne WD,Rosen KM

doi

10.1161/01.cir.53.4.600

subject

Has Abstract

pub_date

1976-04-01 00:00:00

pages

600-4

issue

4

eissn

0009-7322

issn

1524-4539

journal_volume

53

pub_type

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