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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Primary percutaneous coronary intervention ameliorates complete atrioventricular block complicating acute inferior

Su Nam Lee1, You-Mi Hwang1, Gee-Hee Kim1

  • 1Department of Internal Medicine, St Vincent's Hospital, The Catholic University of Korea, Suwon, South Korea.

Clinical Interventions in Aging
|December 5, 2014
PubMed

Insights

Primary percutaneous coronary intervention (PCI) effectively treats complete atrioventricular block (CAVB) in acute inferior ST-elevation myocardial infarction (STEMI). This approach leads to CAVB reversal and comparable major adverse cardiac events, making it the preferred reperfusion therapy.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Acute Myocardial Infarction

Background:

  • Complete atrioventricular block (CAVB) in acute inferior ST-elevation myocardial infarction (STEMI) historically correlates with adverse clinical outcomes.
  • Noninvasive treatments for CAVB in STEMI have shown limited success.

Purpose of the Study:

  • To evaluate the efficacy of primary percutaneous coronary intervention (PCI) in patients experiencing CAVB during acute inferior STEMI.
  • To compare clinical outcomes between patients with and without CAVB undergoing primary PCI.

Main Methods:

  • A single-center study included 138 patients with inferior STEMI, with 27 diagnosed with CAVB.
  • All patients underwent primary PCI; clinical characteristics, procedural details, and outcomes were analyzed.
  • Comparison was made between patients with CAVB and those without.

Main Results:

  • Patients with CAVB were more prone to cardiogenic shock, often due to right coronary artery occlusion.
  • Primary PCI successfully reversed CAVB in all affected patients.
  • Post-PCI, peak creatinine phosphokinase, ejection fraction, and in-hospital mortality were similar between groups.
  • Major adverse cardiac events at 318-day follow-up did not significantly differ between patients with and without CAVB.

Conclusions:

  • Primary PCI is a highly effective reperfusion strategy for acute inferior STEMI complicated by CAVB.
  • This intervention ameliorates CAVB and is associated with acceptable rates of major adverse cardiac events.
  • Primary PCI should be considered the preferred treatment for CAVB complicating acute inferior myocardial infarction.
Abstract

Keywords:
PCI-capable hospitalmajor adverse cardiac events

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