Document Detail


Rapid resolution of new right bundle branch block in acute anterior myocardial infarction patients after thrombolytic therapy.
MedLine Citation:
PMID:  7681169     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The objectives of this retrospective study are to describe the effect of thrombolytic treatment on the clinical course of patients with acute anterior myocardial infarction complicated by acute right bundle branch block. Patients admitted to the intensive cardiac care unit within < 4 hours from onset of symptoms, and demonstrating an acute right bundle branch block with, or without left axis deviation, on the qualifying ECG were included. All were given intravenous thrombolytic treatment consisting of: streptokinase (1,500,000 IU/40 min) or recombinant tissue type plasminogen activator (120 mg/6 hours). Following admission, patients were continuously monitored and a 12-lead ECG was recorded during each of the first 3 hours and then every 3 hours over the next 21 hours. Eight patients were included (8/211 = 3.8%). Their mean age was 62 +/- 7 years and time elapse from onset to treatment was 122 +/- 26 minutes. Complete resolution of the right bundle branch block occurred within < 3 hours in all and left axis deviation normalized in two patients. Mean peak creatine kinase was 1214 +/- 604 IU and global left ventricular ejection fraction, measured by isotope ventriculography within 24 hours from admission, was 39% +/- 15%. Only one patient was prophylactically paced. In the others, rapid normalization of the conduction block with reperfusion exceeded the logistics required for the transvenous pacemaker implantation procedure. Coronary angiography performed in six patients during 72 hours from admission revealed high grade stenoses in the proximal portion of the left anterior descending coronary artery in five patients and complete occlusion in one.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
A Roth; H I Miller; A Glick; G I Barbash; S Laniado
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  16     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1993 Jan 
Date Detail:
Created Date:  1993-04-19     Completed Date:  1993-04-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  13-8     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Tel-Aviv Medical Center, Israel.
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MeSH Terms
Descriptor/Qualifier:
Bundle-Branch Block / epidemiology,  etiology*,  prevention & control
Coronary Care Units
Electrocardiography
Female
Humans
Male
Middle Aged
Myocardial Infarction / complications,  drug therapy*
Pacemaker, Artificial
Retrospective Studies
Streptokinase / therapeutic use
Thrombolytic Therapy*
Time Factors
Tissue Plasminogen Activator / therapeutic use
Chemical
Reg. No./Substance:
EC 3.4.-/Streptokinase; EC 3.4.21.68/Tissue Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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