PROGNOSIS IN PATIENTS WITH DIPHTHERIC MYOCARDITIS AND BRADYARRHYTHMIAS - ASSESSMENT OF RESULTS OF VENTRICULAR PACING

Objective-To determine the prognosis in patients with diphtherial myoc arditis and bradyarrhythmias and to assess the results of ventricular pacing in those with third degree atrioventricular block. Design-Case series. Setting-Referral department of cardiology in a teaching hospit al. Patients-Twenty four out of 46 patients admitted with diphtherial myocarditis over 10 years had bradyarrhythmias. Six had sinus bradycar dia, 15 atrioventricular or intraventricular conduction disturbances, and three atrioventricular dissociation. Main outcome measure-Death ra te. Results-Eleven patients died (46%): all seven patients with third degree atrioventricular block, the patient with bifascicular block, an d three of the six patients with bundle branch block. Seven died of ca rdiogenic shock and four of ventricular fibrillation. All nine patient s with sinus bradycardia or atrioventricular dissociation survived. Co nclusion-Conduction system disturbances in patients with diphtherial m yocarditis are markers of severe myocardial damage and a poor prognosi s. In addition, ventricular pacing does not improve survival.