【正文】 (如藥物中毒，萊姆疾病等 )， 或發(fā)生于無癥狀 OSAS患者低氧時。 Level B 從含有較少量病人的有限次試驗得出的數(shù)據(jù)或從設(shè)計較好的非隨機研究分析得出的數(shù)據(jù)或登記觀察的數(shù)據(jù) . Level C 專家共識是建議的主要來源 . ACC/AHA 臨床證據(jù)分類 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at Section IA: 成人獲得性房室阻滯的起搏治療 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at I 類適應證 : 獲得性房室阻滯的起搏治療 高度 房室阻滯伴 : a)房室阻滯伴可能由心動過緩所致的癥狀 (包括心力衰竭 ) b)需要藥物治療其他心律失常或其他疾病，而所用藥物治療導致癥狀性心動過緩 c)清醒狀態(tài)下雖無癥狀，但證實心室停搏 逸搏心律 40 bpm Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at I 類適應證 : 獲得性房室阻滯的起搏治療 d) 射頻消融后 e) 心臟外科手術(shù) 后發(fā)生的不可逆性房室阻滯 f) 神經(jīng)肌源性疾病伴發(fā)的房室阻滯， 無論是否有癥狀 2. 任何阻滯部位和類型的二度房室阻滯產(chǎn)生的癥狀性心動過緩 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at IIa 類適應證 : 獲得性房室阻滯的起搏治療 ，清醒時平均心室率 40 bpm, 尤其是合并心肌病或左心室功能不全 II型房室阻滯， 伴窄 QRS波。Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at 2021年 ACC/AHA/NASPE 心臟起搏器植入指南 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at ACC/AHA 適應證分類 ? I類 : ? 有明確證據(jù)或?qū)＜覀円恢抡J為起搏治療對患者有益和有效。 倘若QRS為寬大畸形則屬 I類適應證。 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at Section IB: 慢性雙分支和三分支阻滯的起搏治療 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at I 類適應證 : 慢性雙分支和三分支阻滯的起搏治療 II 型房室阻滯 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at IIa 類適應證 : 慢性雙分支和三分支阻滯的起搏治療 ，但可排除可能的其它原因，尤其是室性心動過速后。 I 型房室阻滯，發(fā)生于希氏束以上或不知道發(fā)生在內(nèi)或下。結(jié)論源于包含大數(shù)量病例的多次隨機臨床試驗。 ? II類 : ? 起搏治療是否給患者帶來益處 /有效的研究結(jié)果不一致 /專家們的意見有分歧。 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at IIa 類適應證 : 獲得性房室阻滯的起搏治療 I 型房室阻滯，因其他原因電生理檢查發(fā)現(xiàn)阻滯部位在希氏束內(nèi)或以下水平。 ，但電生理檢查時偶然發(fā)現(xiàn) HV100 ms 生理性阻滯 Gregoratos G.