Natural history of 'high-risk' bundle-branch block: final report of a prospective study
| Autor: | Susan Kauffman, Leonard W. Ritzmann, Paula E. Kanarek, Henry DeMots, John H. McAnulty, Edward L. Murphy, S H Rahimtoola |
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| Rok vydání: | 1982 |
| Předmět: |
Male
Risk medicine.medical_specialty Pacemaker Artificial Heart block Bundle-Branch Block Coronary Disease Sudden death Bifascicular block Syncope Death Sudden Electrocardiography Internal medicine medicine Bradycardia Humans Myocardial infarction Prospective Studies Prospective cohort study Aged Heart Failure medicine.diagnostic_test Bundle branch block business.industry Arrhythmias Cardiac General Medicine Middle Aged medicine.disease Electrophysiology Heart Block Heart failure Cardiology Female business Follow-Up Studies |
| Zdroj: | The New England journal of medicine. 307(3) |
| ISSN: | 0028-4793 |
| Popis: | We conducted a prospective study in which 554 patients with chronic bifascicular and trifascicular conduction abnormalities were followed for an average of 42.4 +/- 8.5 months. Heart block occurred in 19 patients, and 17 were successfully treated. The actuarial five-year mortality from an event that could conceivably have been a bradyarrhythmia was 6 per cent (35 per cent from all causes). Of the 160 deaths 67 (42 per cent) were sudden; most of these were not ascribable to bradyarrhythmia but to tachyarrhythmia and myocardial infarction. Mortality was higher in patients with coronary-artery disease (P less than 0.01) and congestive heart failure (P less than 0.05). Patients in whom syncope developed before or after entry into the study had a 17 per cent incidence of heart block (2 per cent in those without syncope)(P less than 0.05); however, no single variable was predictive of which patients were at high risk of death from a bradyarrhythmia. The predictors of death were increasing age, congestive heart failure, and coronary-artery disease; the predictors of sudden death were coronary-artery disease and increasing age. The risks of heart block and of death from a bradyarrhythmia are low; in most patients, heart block can be recognized and successfully treated with a pacemaker. |
| Databáze: | OpenAIRE |
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