The significance of bundle branch block during acute myocardial infarction

作     者：Nimetz, Allen A. Shubrooks Jr., Samuel J. Hutter Jr., Adolph M. DeSanctis, Roman W. 

作者机构：Department of Medicine Harvard Medical School Boston MA United States the Cardiac Unit Massachusetts General Hospital Boston MA United States 

出 版 物：《American Heart Journal》 (Am. Heart J.)

年 卷 期：1975年第90卷第4期

页      面：439-444页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：U.S. Public Health Service  USPHS  (HL-5196  NO1 HV71663) 

摘      要：Analysis of the course of 71 patients with acute myocardial infarction complicated by bundle branch block (BBB) confirms a high incidence of atrioventricular (A-V) block (42 per cent) and severe pump failure (35 per cent) in these patients. Hospital mortality was not correlated with BBB per se, but rather with the associated development of second or third degree A-V block (57 per cent with A-V block vs. 12 per cent without A-V block;p .0005) or severe pump failure (35 per cent with vs. 11 per cent without severe pump failure;p .001). However, late mortality was high and not significantly different among those surviving hospitalization whether transient A-V block was present or absent. Eight of 11 late deaths were sudden. Temporary pacing could not be shown to alter hospital survival statistically, but made the onset of complete heart block a hemodynamically smooth and clinically undetectable event in several patients who later survived. The place of permanent pacing in these patients cannot be clearly determined on the basis of this study or in the available literature. More data obtained either by pooling the experience of several centers or from a prospective randomized study are needed to determine the indications for permanent pacemakers. © 1975.