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One hundred three patients with persistent sinus bradycardia were evaluated electrophysiologically and followed prospectively for a mean of 4.6 years. The 5-year survival rate was 74.8%, not significantly different from the 72% rate in the general population with similar age and sex distribution. Forty-one patients had abnormal corrected sinus-node recovery time. Overall accuracy of abnormal corrected sinus-node recovery time in predicting serious sinus node disease in symptomatic and asymptomatic patients was 90% (37 of 41 patients) and 100% in patients with syncope (18 of 18 patients). The sensitivity of the test was 66%. Abnormal corrected sinus-node recovery time in patients with sinus bradycardia appears to be a valuable specific, predictive index of serious sinus node disease and therefore a useful test in selecting patients for pacemaker therapy, especially if symptoms such as dizziness or syncope are present. [ABSTRACT FROM AUTHOR]

Of 1125 patients with acute myocardial infarction admitted to Mount Sinai Medical Center in 1971 and 1972, 292 (28.8 percent) had intraventricular conduction defects. In 210 of the 292 patients with intraventricular conduction defect, it was possible to determine if the conduction defect, was present before the infarction (Group 1, 123 patients) or developed acutely with the infarction (Group 2, 87 patients). Of the 210 patients, 52.8 percent died (mean age 72.1 years). Fifty-three patients in Group 1 and 18 patients in Group 2 had isolated left axis deviation (LAD). The mortality was 35 percent and 28 percent respectively. This difference was not significant (p greater than 0.60). Sixty-four of the 210 patients presented with a left bundle branch block (LBBB) pattern. The overall mortality of 54 percent was the same in both groups. Right bundle branch block(RBBB), with either normal axis, left (LAD) or right axis deviation (RAD), was found in 74 patients. Of 40 patients in Group 1, 62 percent died, and of 35 patients in Group 2, 80 percent expired. Again this difference was not significant (p greater than 0.10). In 13 of 25 patients with RBBB in Group 1, death was possible related to progression of the conduction defect. The use of prophylactic temporary pacing is suggested for these patients.