On inserting a temporary pacemaker for heart bifascicular block in perioperative period / 第三军医大学学报

ABSTRACT

Objective To investigate the indications to use a temporary pacemaker for bifascicular block in perioperative period.Methods The treatment for 40 patients with heart bifascicular block and a special case were retrospectively studied.All cases,according to their disease history,clinical symptoms,physical ability and atrio-ventricular conduction ability,were divided into two groupsP group(prophylactic insertion of a temporary pacemaker) and N group(without inserting a pacemaker).During operation,we observed whether atrio-ventricular block occurs,the performance of pacemaker and atropine's therapeutic efficacy to bradycardia.Results Anesthesia was postponed in one case because of acute left bundle branch block(LBBB) and the patient died with severe myocardium damage soon after failed resuscitation.All other cases went through anesthesia and operation smoothly.Bradycardia and hypotension could be relieved somewhat by medication in operation,and no complete atrio-ventricular block developed.Conclusion There is no need inserting a temporary pacemaker for chronic bifascicular block if asymptomatic and no atrio-ventricular block.Transesophageal atrial pacing is an easy way to evaluate in quantification atrio-ventricular conduction ability.