TY - JOUR
T1 - Natural history of chronic second-degree atrioventricular nodal block
AU - Strasberg, B.
AU - Amat-Leon, Y. F.
AU - Dhingra, R. C.
PY - 1981
Y1 - 1981
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=0019491591&partnerID=8YFLogxK
U2 - 10.1161/01.CIR.63.5.1043
DO - 10.1161/01.CIR.63.5.1043
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
AN - SCOPUS:0019491591
SN - 0009-7322
VL - 63
SP - 1043
EP - 1049
JO - Circulation
JF - Circulation
IS - 5
ER -