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His bundle electrogram in patients with acute myocardial infarction
Insights
Patients with acute myocardial infarction and conduction blocks experienced high mortality, mainly due to pump failure. His-ventricular (H-V) interval prolongation did not significantly impact mortality in these cardiac patients.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Acute myocardial infarction (AMI) can lead to conduction abnormalities.
- Atrioventricular (AV) block and bundle branch block (BBB) are significant complications of AMI.
Purpose of the Study:
- To investigate the impact of His bundle electrogram (HBE) findings, specifically the H-V interval, on acute mortality in AMI patients with conduction blocks.
Main Methods:
- His bundle electrogram studies were performed on 37 patients with AMI and complicating AV or BBB during their coronary care unit stay.
- Patients were analyzed based on the type of conduction block (BBB, inferior MI, anterior MI) and H-V interval duration.
Main Results:
- Patients with complicating BBB had 50% acute mortality, primarily from pump failure. H-V interval did not correlate with mortality in this group.
- Patients with inferior wall MI had 6% mortality, with normal H-V intervals in most cases.
- Patients with anterior wall MI had 29% mortality, with pump failure as the cause of death. Prolonged H-V interval did not affect mortality.
Conclusions:
- Conduction blocks in AMI significantly increase acute mortality, with pump failure being the leading cause.
- The H-V interval, as assessed by HBE, does not appear to be a reliable predictor of acute mortality in AMI patients with AV or BBB.
Abstract:
Thirty-seven patients with acute myocardial infarction complicated by atrioventricular or bundle branch block, or a combination of both, has His bundle electrogram studies performed during their stay in the coronary care unit. The acute mortality of the 14 patients with a complicating bundle branch was 50%. Pump failure was the main cause of death. Three patients in this group had a prolonged H-V interval and one patient had a split blundle of His. The presence or absence of a prolonged H-V interval did not affect mortality in this group of patients. The acute mortality of the 16 patients with an inferior wall myocardial infarction was 6%. The H-V interval was normal in all but one of these patients. The atrioventricular block was caused by a proximal block in all cases. The acute mortality of the seven patients with an anterior wall myocardial infarction was 29%. The H-V interval was prolonged in two of seven patients. Pump failure was the acute cause of the deaths. The presence or absence of a prolonged H-V interval did not affect mortality in this group of patients.