Value of the H-Q interval in patients with bundle branch block and the role of prophylactic permanent pacing
| Autor: | Jawahar Desai, Melvin Scheinman, Katherine M. Williams, Barry Wohl, John Cogan, Joseph A. Abbott, Mary Jane Sauvé, Robert W. Peters |
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| Rok vydání: | 1982 |
| Předmět: |
Risk
Bundle of His medicine.medical_specialty Bundle-Branch Block Population Sudden death Electrocardiography Internal medicine Humans Medicine In patient Risk factor education Aged education.field_of_study Bundle branch block medicine.diagnostic_test business.industry Incidence (epidemiology) Cardiac Pacing Artificial Middle Aged medicine.disease Heart Block Anesthesia Cardiology Cardiology and Cardiovascular Medicine business Atrioventricular block Follow-Up Studies |
| Zdroj: | The American Journal of Cardiology. 50:1316-1322 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/0002-9149(82)90469-6 |
| Popis: | His bundle electrograms were obtained in 313 patients with chronic bundle branch block who were followed for a mean period of almost 3 years. The infranodal conduction time (H-Q interval) was less than 55 ms in 97 patients (Group I), 55 to 69 ms in 99 patients (Group II), and greater than or equal to 70 ms in 117 patients (Group III). There was a higher incidence of organic heart disease in patients in Group III, but the groups were otherwise comparable. On follow-up study, mortality and the incidence of sudden death were similar among the groups, but patients in Group III had a greater incidence of progression to high degree atrioventricular block (HDB) than did those in Groups I and II (14 of 117 [12%] versus 4 of 97 [4%] and 2 of 99 [2%], p less than 0.01, respectively). High degree block was found in 4 of 17 (24%) patients with an H-Q interval (H-Q) greater than or equal to 100 ms. Sixty-two patients underwent permanent prophylactic pacemaker insertion at the discretion of the referring physician and were compared with 231 patients who did not. Paced patients had a higher incidence of transient neurologic symptoms and prolonged H-Q, but the groups were otherwise comparable. On follow-up study, mortality and the incidence of sudden death were similar among the groups, but symptom relief was significantly more common among patients with pacemakers. In conclusion, in our population (1) H-Q greater than or equal to 70 ms was an independent risk factor for progression to HDB, (2) H-Q greater than or equal to 100 ms identified a subgroup at particularly high risk, and (3) prophylactic pacemakers relieved neurologic symptoms but did not prolong life. |
| Databáze: | OpenAIRE |
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