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Can revascularization restore sinus rhythm in patients with acute onset atrioventricular block?

Suat Nail Omeroglu1, Hasan Ardal, Hasan Basri Erdogan

  • 1Department of Cardiovascular Surgery, Kosuyolu Heart and Research Hospital, Istanbul, Turkey. suatnail@yahoo.com

Journal of Cardiac Surgery
|February 24, 2005
PubMed

Insights

Coronary artery bypass grafting (CABG) did not restore sinus rhythm in patients with acute complete atrioventricular (AV) block. Revascularization is not a cure for AV block in these coronary artery disease patients.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Electrophysiology

Background:

  • Patients with coronary artery disease (CAD) and acute complete atrioventricular (AV) block often require intervention.
  • Coronary artery bypass grafting (CABG) is a surgical treatment for severe CAD.
  • The potential for revascularization to restore sinus rhythm in this specific patient group is unclear.

Purpose of the Study:

  • To investigate whether coronary artery bypass grafting (CABG) can restore normal sinus rhythm in patients experiencing acute complete atrioventricular (AV) block.
  • To assess the safety and efficacy of CABG in patients with coexisting severe coronary artery disease and complete AV block.

Main Methods:

  • Eight patients with severe CAD and newly developed complete AV block underwent CABG.
  • Revascularization procedures focused on the left anterior descending artery in all patients, with complete revascularization achieved in six.
  • Patients were monitored for approximately 10 days post-CABG for potential recovery of AV conduction before permanent pacemaker implantation.

Main Results:

  • No operative or early mortality was observed.
  • None of the patients recovered from complete AV block following coronary revascularization.
  • Mean follow-up was over 23 months, with all patients remaining asymptomatic after pacemaker implantation.

Conclusions:

  • Acute complete AV block did not negatively impact the outcomes of CABG surgery.
  • Coronary revascularization, performed approximately 3.6 days after AV block onset, is ineffective in restoring sinus rhythm.
  • Permanent pacemaker implantation remains necessary for patients with persistent AV block post-CABG.
Abstract

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