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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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High Degree Atrioventricular Block Complicating Acute Myocardial Infarction Treated with Primary Percutaneous

Yacov Shacham, Eran Leshem-Rubinow, Arie Steinvil

    The Israel Medical Association Journal : IMAJ
    |July 4, 2015
    PubMed

    Insights

    High degree atrioventricular block (AVB) in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI) is transient but a significant predictor of mortality. This study highlights AVB as a key prognostic marker in STEMI patients.

    Area of Science:

    • Cardiology
    • Interventional Cardiology
    • Electrophysiology

    Background:

    • Limited data exists on high-degree atrioventricular block (AVB) incidence and prognosis in ST-elevation myocardial infarction (STEMI) patients receiving primary percutaneous coronary intervention (PPCI).
    • Understanding AVB in the PPCI era is crucial for risk stratification and management.

    Purpose of the Study:

    • To determine the incidence, onset, predictors, and prognostic impact of high-degree AVB in a large STEMI cohort undergoing PPCI.
    • To evaluate the association between AVB and short-term/long-term mortality.

    Main Methods:

    • Retrospective analysis of 1244 consecutive STEMI patients treated with PPCI.
    • Review of patient records for high-degree AVB, timing, in-hospital complications, and 5-year mortality.
    • Multivariate regression analysis to identify independent predictors of mortality.

    Main Results:

    • High-degree AVB occurred in 3.0% of STEMI patients, predominantly before PPCI (76%).
    • AVB was linked to significantly higher 30-day (15% vs. 2.0%) and long-term mortality (30% vs. 6.0%).
    • AVB independently predicted long-term mortality (HR 2.8).

    Conclusions:

    • High-degree AVB is a transient but significant prognostic marker in STEMI patients treated with PPCI.
    • Early identification and management of AVB may be important for improving outcomes in STEMI.
    Abstract

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