Document Detail

Clinical and angiographic findings of complete atrioventricular block in acute inferior myocardial infarction.
MedLine Citation:
PMID:  20372753     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: The angiographic findings and prognosis of patients with complete atrioventricular block (AVB) complicating acute inferior myocardial infarction (MI) remain unclear. MATERIALS AND METHODS: The clinical and angiographic findings of 70 consecutive patients with complete AVB were compared with those of 319 patients with inferior MI without AVB (control group) admitted within the same study period. RESULTS: Patients with complete AVB were older (68 +/- 12 vs 63 +/- 13 years; P = 0.004) and clustered with clinical features indicative of larger infarct size, such as right ventricular infarction, cardiogenic shock, or low left ventricular ejection fraction (LVEF). The onset of the complete AVB was observed within 24 hours in 62 (88.6%), preceded by second-degree AVB in 26 (37.1%) and the escape QRS complex was wide in 8 (11.4%) patients. In patients with complete AVB, a dominant right coronary artery occlusion was found in >95% of cases and in-hospital mortality was increased (27.1% vs 10.7%; P = 0.000), especially in those with widen QRS escape rhythm (75.0%). Reperfusion therapy had a positive impact on the natural course of complete AVB. CONCLUSIONS: Complete AVB in acute inferior MI was associated with advanced age and larger infarct size. Complete AVB was virtually always caused by dominant right coronary artery occlusion. The in-hospital mortality was significantly higher, but improved by reperfusion therapy. No permanent pacemaker is performed at a mean follow-up of 47 months.
Man-Hong Jim; Annie O O Chan; Hung-Fat Tse; Serge S Barold; Chu-Pak Lau
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Annals of the Academy of Medicine, Singapore     Volume:  39     ISSN:  0304-4602     ISO Abbreviation:  Ann. Acad. Med. Singap.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-04-07     Completed Date:  2010-08-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7503289     Medline TA:  Ann Acad Med Singapore     Country:  Singapore    
Other Details:
Languages:  eng     Pagination:  185-90     Citation Subset:  IM    
Cardiac Medical Unit, Grantham Hospital, Hong Kong, University of Hong Kong.
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MeSH Terms
Age Factors
Aged, 80 and over
Atrioventricular Block / complications*,  mortality,  radiography*
Coronary Angiography*
Electrocardiogram Pattern
Hong Kong / epidemiology
Hospital Mortality
Inferior Wall Myocardial Infarction / complications*,  mortality,  radiography*
Kaplan-Meiers Estimate
Middle Aged

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