Abstract
Ninety-eight patients with ECG evidence of bifascicular
block who had undergone general anesthesia and
surgery have been followed up. His bundle electrogram
was recorded in all patients prior to the surgery.
On the basis of electrophysiologic studies, patients were
classified in two groups: normal H-V group (47 patients)
and prolonged H-V group (51 patients). The
prolonged H-V group presented a significantly greater
incidence of organic heart disease and cardiac symptoms.
Correspondingly, there was a significantly higher
incidence of cardiac intra- and postoperative complications
in patients with prolonged H-V interval, but none
of the patients developed complete heart block. Venfricular
fibrillation and not the occurrence of complete heart block, was the cause of sudden cardiac death in
three patients who had a prolonged H-V interval and
severe organic heart disease. Patients with bifascicular
block, undergoing anesthesia and surgery, even in the
presence of presumable risk factors, do not require
prophylactic pacing. The H-V duration represents a
more accurate predictor of major cardiac intra- and
postoperative complications than the surface recordings,
but only in patients with symptomatic heart disease.
These data support the concept that high-risk
patients can be identified clinically and thus preoperative
determinations of H-V intervals should not be recommended
Lingua originale | English |
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pagine (da-a) | 343-348 |
Numero di pagine | 6 |
Rivista | Chest |
Volume | 77 |
Stato di pubblicazione | Pubblicato - 1980 |
Pubblicato esternamente | Sì |
Keywords
- BIFASCICULAR BLOCK