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[Classification of patients with complete atrioventricular block according to etiological, demographic and clinical
Omer Alyan1, Ozcan Ozdemir, Mustafa Soylu
1Clinic of Cardiology, Türkiye Yüksek Ihtisas Hospital, Ankara Turkey. mendikan@yahoo.com
Insights
Complete atrioventricular (AV) block is a serious heart rhythm disorder. Acute myocardial infarction and older age significantly increase mortality risk in these patients.
Area of Science:
- Cardiology
- Electrophysiology
- Internal Medicine
Context:
- Complete atrioventricular (AV) block is a significant cardiac rhythm disturbance with diverse etiologies.
- Understanding the factors influencing its prognosis is crucial for patient management.
Purpose:
- To investigate the etiological factors, clinical presentations, and outcomes of complete AV block.
- To identify predictors of in-hospital mortality and pacemaker requirements.
Summary:
- Ischemia was the leading cause of complete AV block, followed by unknown and iatrogenic factors.
- Acute myocardial infarction and advanced age were identified as key mortality predictors.
- Pacemaker implantation did not influence mortality rates in this patient cohort.
Impact:
- This study provides valuable insights into the management of complete AV block.
- Identifying high-risk patients can guide therapeutic strategies and improve clinical outcomes.
Objective:
Complete atrioventricular (AV) block is a rhythm disorder that can result from various causes. The aim of this study was to define etiological factors, clinical features, pacemaker needs, in-hospital mortality rates and factors affecting these parameters in the patients with complete AV block.
Methods:
For this aim, 191 consecutive patients admitted to the hospital with complete AV block or who developed AV block during their hospital course between January 1999-September 2002 were included into the study.
Results:
The most common underlying cause of AV block was found to be the ischemia, which was followed by unknown etiology and iatrogenic complete AV block. The most common cause of in-hospital mortality was ischemic (especially acute) heart disease. No etiological factor for complete AV block was found in most of symptomatic patients presented with syncope. In patients with ischemic complete AV block, mortality and syncope rates were found to be high, especially in patients with multivessel disease. Permanent pacemaker was implanted in 76 of 191 patients with complete AV block and the significant portion of these patients were those without an etiological cause.
Conclusion:
Thus, it is revealed that factors affecting mortality in patients with complete AV block are acute myocardial infarction and age while other clinical parameters and pacemaker implantation had no effects on mortality.