Related Experiment Videos
[The Wenckebach phenomenon in patients with acute myocardial infarction]
S Férez1, S Guizar, M Cárdenas
1Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
Abstract:
To show the incidence of second degree Auriculoventricular block (AVB) with Wenckebach phenomenon (WF) 1336 patients with acute myocardial Infarction (AMI) were studied. We found 67 cases with WF 5.0% from the total group of AMI and the 33.83% form the group with any type of AVB. Fifty three were male and 14 female (4:1). 77.5% arrived to ICU for their first AMI and 22.38% for their second AMI. 43.26% were posteroinferior with extension to right ventricule; 36.0% pare posteroinferior, 10.4% anterolateral; 9.0% posterolaterals and 1.4% lateral. The onset time of WF in relation to the AMI set was 64.2% in the first 24 hours; and 17.9% for the 24-48 hour group as well as for those over 48 hours. The duration of the WF in 43.3% was lees than 24 hours 19.4%; between 24-48 hours; 25.4% more than 48 hours and 11.9% was transient. The WF was always present with heart rate under 110x'. In 9 patients it occurred with sinus bradycardia with a 48 to 40x' heart rate. The QRS duration was from 80 to 90 msec in 91.0% and from 100 to 120 msec in 9.0%; 4.47% of them had right bundle branch block previous to WF. 10.4% had progression to Mobitz II and 11.9% lead to complete AVB. Mortality was the 2.98% in the group their first AMI; and 4.47% in the group with their second AMI.
Insights
Wenckebach phenomenon (WF) occurred in 5.0% of acute myocardial infarction (AMI) patients. This second-degree atrioventricular block often appeared within 24 hours and could progress to complete heart block.
Area of Science:
- Cardiology
- Electrophysiology
- Internal Medicine
Context:
- Acute myocardial infarction (AMI) is a leading cause of cardiovascular morbidity and mortality.
- Atrioventricular block (AVB) is a known complication of AMI, affecting cardiac conduction.
- Second-degree AVB, specifically Wenckebach phenomenon (WF), requires detailed investigation regarding its incidence and clinical implications in AMI.
Purpose:
- To determine the incidence of second-degree atrioventricular block with Wenckebach phenomenon (WF) in patients with acute myocardial infarction (AMI).
- To analyze the characteristics of WF, including onset time, duration, associated heart rates, and electrocardiographic findings.
- To evaluate the progression of WF and its impact on mortality in the AMI patient cohort.
Summary:
- A study of 1336 AMI patients identified 67 cases (5.0%) with WF, representing 33.83% of all AVB cases.
- WF predominantly affected males (4:1 ratio) and occurred within the first 24 hours in 64.2% of cases, often associated with sinus bradycardia.
- While 10.4% progressed to Mobitz II block and 11.9% to complete AVB, overall mortality was low (2.98% for first AMI, 4.47% for second AMI).
Impact:
- This study quantifies the incidence of WF in AMI, providing crucial data for risk stratification and management strategies.
- Understanding the temporal patterns and progression of WF aids in predicting patient outcomes and guiding clinical interventions.
- The findings highlight the importance of vigilant electrocardiographic monitoring in AMI patients to detect and manage conduction abnormalities like WF effectively.