"Este estudio describe la historia natural y evolucion de 67 pacientes con bloqueo auriculoventricular (BAV) completo congenito ingresados en el Instituto Nacional de Cardiologia "Ignacio Chavez", Mexico, D.F. de 1944 a 1998. Fueron 35 (52 por ciento) mujeres y 32 (47 por ciento) hombres, con un periodo de seguimiento medio de 93.7 n 104 meses, la mayoria de los pacientes tenian corazon estructuralmente sano (90 por ciento). Los sintomas mas comunes fueron disnea y sincope. El electrocardiograma mostro una frecuencia ventricular media de 42.2 n 9 latidos/minuto en pacientes con sincope. El intervalo QTc promedio fue 403 n 60 ms. El 85.7 por ciento de los pacientes tuvieron un BAV suprahisiano. En 31 po ciento de los pacientes se implanto un marcapasos definitivo debido a sincope. La mortalidad general fue de 4.4 por ciento y las arritmias ventriculares malignas fueron las contribuyentes principales. Los factores de riesgo para mortalidad, identificados en este estudio, fueron ritmo de escape de la union AV menor de 50 latidos/minuto, respuesta cronotropica inapropiada durante el ejercicio, prolongacion del intervalo R-R durante la noche, dilatacion de cavidades cardiacas, fraccion de eyeccion ventricular izquierda deprimida y prolongacion del QTc. En todas estas condiciones nosotros recomendamos la implantacion de un marcapasos permanente(AU)."@es
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