[The natural course of a complete atrioventricular block]
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The first Morgagni-Adams-Stokes (MAS) attack in patients with atrioventricular blockade indicates pacemaker implantation. Early intervention significantly improves long-term survival rates for these patients.
Area of Science:
- Cardiology
- Electrophysiology
Context:
- Analysis of 311 patients with atrioventricular blockade undergoing surgical treatment.
- Focus on the natural disease progression and outcomes.
Purpose:
- To analyze the natural disease course of atrioventricular blockade.
- To determine the prognostic significance of Morgagni-Adams-Stokes (MAS) attacks.
- To establish indications for permanent cardiac pacemaker implantation.
Summary:
- Morgagni-Adams-Stokes (MAS) attacks typically do not occur for 2-3 years after onset, influencing life expectancy.
- The first MAS attack in atrioventricular blockade is an absolute indication for permanent pacemaker implantation.
- Survival rates after pacemaker implantation: 1-year (91.1%), 3-year (85.8%), 5-year (77.3%), 7-year (63.2%), 8-year (60.8%).
Impact:
- Highlights the critical timing for intervention in atrioventricular blockade.
- Demonstrates the life-extending benefits of permanent cardiac pacemakers.
- Provides crucial data for clinical decision-making in managing atrioventricular blockade and MAS attacks.
Abstract:
The natural disease course is analyzed in 311 patients with atrioventricular blockade admitted for surgical treatment to the Leningrad Center of Arrhythmia Surgery and Cardiac Pacing. It has been discovered that, as a rule, Morgagni-Adams-Stokes (MAS) attacks do not occur for over 2-3 years after their onset, which determines to a considerable measure the patients: life expectancy. The authors hold that the very first Mas attack which may occur in a patient with atrioventricular blockade is an absolute indication for implantation of a permanent cardiac pacemaker. If the permanent cardiac pacemaker was established, 1-, 3-, 5-, 7- and 8-year survival rates were, respectively, 91.1, 85.8, 77.3, 63.2, and 60.8%.