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Percutaneous coronary intervention for persistent complete heart block complicating inferior myocardial infarction

S Ramamurthy1, S Anandaraja, Navin Matthew

  • 1Department of Cardiology, Ste. 25, All India Institute of Medical Sciences, New Delhi, India. saraja79@yahoo.com

The Journal of Invasive Cardiology
|January 9, 2008
PubMed

Insights

For inferior myocardial infarction (MI), percutaneous coronary intervention (PCI) can reverse persistent heart block, potentially avoiding permanent pacemaker implantation. This approach offers an alternative to traditional guidelines in selected cases.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Electrophysiology

Background:

  • Advanced atrioventricular block complicating acute myocardial infarction (MI) often necessitates permanent pacemaker implantation if persistent beyond the typical hospital course.
  • Inferior MI-associated heart block is typically transient but can persist, posing a management challenge.
  • Current guidelines do not prioritize percutaneous coronary intervention (PCI) for persistent heart block in MI without ongoing ischemia.

Observation:

  • A case study involving a patient with inferior MI and persistent complete heart block is presented.
  • The patient underwent successful percutaneous coronary intervention (PCI).

Findings:

  • Percutaneous coronary intervention (PCI) effectively reversed the persistent complete heart block in this patient.
  • The successful PCI obviated the need for permanent pacemaker implantation.

Implications:

  • PCI may be a viable treatment option for selected patients with inferior MI and advanced atrioventricular block.
  • Considering PCI before permanent pacemaker implantation could alter current management strategies.
  • This case highlights a potential role for early reperfusion in managing complex heart block post-MI.

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