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Early and late advanced atrioventricular block in acute inferior myocardial infarction
1Trakya University, Faculty of Medicine, Cardiology Department, Edirne, Turkey.
Insights
The timing of advanced atrioventricular block in inferior acute myocardial infarction (AMI) does not impact patient prognosis. Early or late onset of this complication, requiring pacemaker therapy, showed similar outcomes in hospitalized patients.
Area of Science:
- Cardiology
- Clinical Medicine
- Medical Research
Background:
- Advanced atrioventricular block is a common complication of inferior acute myocardial infarction (AMI).
- This condition is associated with increased in-hospital mortality and other complications.
- Limited data exist on the prognostic implications of early versus late advanced atrioventricular block in inferior AMI.
Purpose of the Study:
- To investigate whether the timing of advanced atrioventricular block onset influences prognosis in inferior AMI patients.
- To compare outcomes between patients with early-onset (within 24 hours) and late-onset (after 24 hours) advanced atrioventricular block.
Main Methods:
- A study of 51 patients with inferior AMI and advanced atrioventricular block unresponsive to atropine, requiring temporary pacing.
- Patients were categorized into an early block group (n=30, within 24 hours) and a late block group (n=21, after 24 hours).
- Comparison of clinical characteristics, arrhythmias, heart failure, and mortality between the two groups.
Main Results:
- Both early and late block groups showed similar outcomes regarding age, risk factors, QRS score, heart rates, time to first-degree atrioventricular block, arrhythmias, heart failure, and mortality.
- A higher proportion of men were observed in the early advanced atrioventricular block group (P = 0.017).
Conclusions:
- The time of onset for advanced atrioventricular block in inferior AMI does not appear to affect the prognosis for hospitalized patients.
- Clinical management strategies for advanced atrioventricular block in inferior AMI may not need to differentiate based on timing of onset.
Background:
Advanced atrioventricular block is a frequent complication in patients with inferior acute myocardial infarction (AMI); in patients in hospital, it often occurs concurrently with other complications and is associated with high mortality. Very little information is available about early and late advanced atrioventricular block in inferior AMI. We hypothesized that the time of appearance of advanced atrioventricular block characterized by poor response to atropine requiring temporary pacemaker therapy may affect the prognosis of patients with inferior AMI.
Methods:
We studied 51 patients with inferior AMI and advanced atrioventricular block characterized by poor response to atropine requiring temporary pacemaker therapy. According to pre-established electrocardiographic criteria and the time of appearance of the advanced atrioventricular block, patients were divided into two groups: an early block group consisting of 30 patients who developed advanced atrioventricular block during the first 24 h of inferior AMI, and a late block group consisting of 21 patients who developed advanced atrioventricular block after the first 24 h of chest pain.
Results:
The groups were similar regarding age, coronary risk factors, frequency of right ventricular infarction, QRS score, atrial and ventricular rates, the time of return to first-degree atrioventricular block, cardiac arrhythmias, heart failure and mortality. The early advanced atrioventricular block group included a greater number of men than did the late group (P = 0.017).
Conclusion:
These data suggest that the time of appearance of advanced atrioventricular block does not affect the prognosis of hospital patients with inferior AMI.