| Background:Paroxysmal complete atrioventricular block is characterized by intermittence and unpredictability,so the diagnosis of paroxysmal complete atrioventricular block used to be missed and overlooked.It’s difficult for us to predict the development of the paroxysmal complete atrioventricular block.The onset of the disease is often accompanied by ventricular asystole,leading to sudden death.Therefore,paroxysmal complete atrioventricular block is life-threatening.Based on the factors discussed above,it’s important to be familiar with the paroxysmal complete atrioventricular block comprehensively.At present,the disease still lacks of reliable factors,in addition,most cases of the paroxysmal complete atrioventricular block are required to be implanted with a permanent pacemaker.With development of the technology of pacemaker,the application of dual chamber pacemaker has been the mainstream trend.For patients with paroxysmal complete atrioventricular block who received a permanent dual chamber pacemaker,which factors impact on their percent ventricular pacing is yet to be established.Objective:To be familiar with clinical feature of the paroxysmal complete atrioventricular block comprehensively.By analyzing the programming information,including percentage of ventricular pacing,in order to know the prognosis of the paroxysmal complete atrioventricular block.Based on the cumulative percentage of ventricular pacing,analyse which factors are likely to have a relationship with the percentage of ventricular pacing.For physicians,this study is possible to be better to provide references to clinical management about paroxysmal complete atrioventricular block.Methods:Results:A total of 51 patients were included in the study,including 26 males and 25 females.The mean age was 66.91±12.38 years,LVEF 58.0010.02%,heart failure in all patients was with normal left ventricular ejection fraction,NYHA:Ⅱ-Ⅳ degree.Evidence of distal conduction disease at baseline was present in 19(37.3%),including:8(15.7%)had right bundle branch block(RBBB),3(5.9%)had left anterior hemi-block(LAH),4(7.8%)had left bundle branch block(LBBB).2(3.9%)had RBBB +intermittent LBBB,1(2%)had RBBB+LAH.Prolonged ventricular diastolic period often fluctuated 6.5±4.9 seconds.Which factors precipitated complete atrioventricular block were 16(31.4%)atrial premature beat,11(21.6%)ventricular premature beat,9(17.6%)Ⅱ-degree atrioventricular block(2:1),6(11.8%)supraventricular tachycardia,there were also 9(17.6%)without any precipitating factors.All patients were implanted with dual-chamber pacemaker successfully.The median follow-up time was 13 months.There were 5(9.8%)patients who had developed into 100%ventricular pacing.Compared to patients with age blow or equal to 70 years,there was a relatively higher cumulative percentage of ventricular pacing among patients with age above 70 years(60.10±34.15%vs.35.43±42.80%,P<0.05).Compared to patients without diabetes mellitus,there was a relatively higher cumulative percentage of ventricular pacing among patients with diabetes mellitus(69.44±29.44%vs.41.16±42.66%,P<0.05).Compared to patients without heart failure,there was a relatively higher cumulative percentage of ventricular pacing among patients with heart failure(52.91±39.72%vs.38.39±42.83%,P<0.05).However,gender,coronary heart disease,coronary atherosclerosis,bundle branch block,beta-blockers,angiotensin converting enzyme inhibitor/angiotensin receptor blockers and calcium channel blockers were seemly not related to the percentage of ventricular pacing.Conclusions:1.Paroxysmal atrioventricular block always happens among elderly population with evidence of distal conduction disease at baseline.2.There were about 10%patients with paroxysmal complete atrioventricular block after implantation of dual chamber pacemaker who had been developed into 100%ventricular pacing,implying paroxysmal complete atrioventricular block is easy to developed into persist complete atrioventricular block.3.Age>70years,diabetes mellitus,heart failure are factors which are related to higher percentage of ventricular pacing after dual chamber pacemaker implantation.Patients with these characteristics are more likely to depend on ventricular pacing. |
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