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本文报道先天性心脏病心内直视术后并发完全性房室传导阻滞14例的治疗及随访结果,13例术毕置右心室外膜临时起搏导线,其中11例启用临时起搏治疗1.7～60天;10例同时使用异丙基肾上腺素。9例术后1.7～30天(11.2±9.3天)恢复窦性节律,随防中(4月～6年)无1例复发完全性房室传导阻滞。5例未恢复窦性节律者中4例置埋藏式永久性起搏器,1例存活良好(2年);3例术后1年内死亡;另1例未置起搏器者3年后意外事故中死亡。术后暂时性及永久性完全性房室传导阻滞时心室率分别为68.4±17.7次/分及70.6±15.4次/分,QRS波宽为0.1±0.02秒及0.108±0.009秒,均无显著差异(P>0.05)。完全性房室传导阻滞时的心室率及QRS波宽度不能预示能否恢复窦性节律。
This article reports the treatment and follow-up results of 14 cases of congenital heart disease complicated with atrioventricular block followed by open heart surgery. 13 cases were performed temporary right ventricular epidural pacing lead, of which 11 cases of temporary pacing therapy 1.7 to 60 days; 10 cases of simultaneous use of isoproterenol. The sinus rhythm was restored in 9 cases 1.7 ~ 30 days postoperatively (11.2 ± 9.3 days). There was no recurrence of complete atrioventricular block in 1 case (4 months to 6 years). Among the 5 patients who did not recover sinus rhythm, 4 were implanted permanent pacemakers, 1 survived well (2 years), 3 died within 1 year after operation, and 3 patients were uninvolved with pacemaker after 3 years Death in accident. The postoperative ventricular rates were 68.4 ± 17.7 and 70.6 ± 15.4, respectively, and the QRS wave widths were 0.1 ± 0.02 and 0.108 ± 0.009, respectively, with no significant difference after temporary and permanent complete atrioventricular block Difference (P> 0.05). Ventricular rate and QRS width at complete atrioventricular block do not predict whether sinus rhythm can be restored.