Natural history of chronic second-degree atrioventricular nodal block

B. Strasberg, Y. F. Amat-Leon, R. C. Dhingra

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99 Scopus citations

Abstract

This report details our experience with documented chronic second-degree atrioventricular (AV) nodal block (proximal to His [H] in 56 patients. Forty-six men (82%) and 10 women (18%), ages 18-87 years, were studied. Nineteen of the patients (34%) had no organic heart disease (including seven trained athletes) and 37 (66%) had organic heart disease. ECGs in all patients demonstrated episodes of type I second-degree block; five patients also had periods of 2:1 block. Prospective follow-up of patients with no organic heart disease (157-2280 days, mean 1395 ± 636 days) revealed one patient with clear indication for permanent pacing because of bradyarrhythmic symptoms (permanently placed on day 220 of follow-up). Two patients died. In patients with organic heart disease (prospective follow-up of 60-2950 days, mean 1347 ± 825 days), pacemakers were implanted in 10 patients, primarily for treatment of congestive heart failure in eight and syncope in two. Sixteen patients died - three suddenly, seven with congestive heart failure, two of an acute myocardial infarction and four of causes unrelated to cardiac disease. In summary, chronic second-degree AV nodal block had a relatively benign course in patients without organic heart disease. In patients with organic heart disease, prognosis is poor and related to the severity of underlying heart disease.

Original languageEnglish
Pages (from-to)1043-1049
Number of pages7
JournalCirculation
Volume63
Issue number5
DOIs
StatePublished - 1981
Externally publishedYes

Funding

FundersFunder number
National Heart, Lung, and Blood InstituteR01HL018794

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