Early and late atrioventricular block in acute inferior myocardial infarction

Feigl, D; Ashkenazy, Jacob; Kishon, Yehezkiel

doi:10.1016/s0735-1097(84)80315-0

Cited by 111 publications

(31 citation statements)

References 14 publications

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“…[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Approximately one half of the patients who develop heart block do so through a gradual progression of their conduction delay, whereas the remainder abruptly develop the highest degree of heart block they will attain.89,12,15,2' The timing of the onset of the heart block in acute inferior infarction is presented in Table 2. 9,15,16,22,23 Roughly 8% of all patients who have an inferior infarction have highdegree heart block on arrival at the emergency department, and approximately two thirds of the patients who are eventually going to develop highdegree heart block have done so within 24 hours of admission. Virtually all the remaining patients who develop heart block do so within 3 days of admission.…”

Section: U Clinical Progress Series Inferior Myocardial Infarctionmentioning

confidence: 99%

Inferior myocardial infarction. High-risk subgroups.

Berger¹,

Ryan²

1990

Circulation

260

154

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Section: U Clinical Progress Series Inferior Myocardial Infarctionmentioning

confidence: 99%

Inferior myocardial infarction. High-risk subgroups.

Berger¹,

Ryan²

1990

Circulation

260

154

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“…4,23) Additionally, previous studies have also demonstrated that CHB can completely recover in a majority of patients following AMI. [1][2][3][4] This could be due to spontaneous recanalization of the IRA or the development of new intercoronary collateral circulation which, in turn relieves the ischemia of the atrionodular artery. Thus, this study extended the findings of these studies, [1][2][3][4]23) further supporting the concept that ischemia 24) is the primary reason for CHB in the clinical setting of AMI.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] Patients with CHB are significantly more likely to die during hospitalization than patients without CHB. [4][5][6][7][8][9] The duration of CHB varies dramatically from a few minutes to more than 10 days and permanent pacemaker implantation is very seldom required.…”

mentioning

confidence: 99%

Impact of PercuSurge GuardWire Device on Prevention and Reduction of Recovery Time From Complete Heart Block in Patients With Acute Inferior Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Chiu¹,

Youssef

et al. 2007

Int. Heart J.

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SUMMARYSecond-degree heart block or complete heart block (CHB) is a relatively frequent complication of acute inferior wall myocardial infarction (AIWMI). This study investigated whether the PercuSurge device can prevent procedure-related CHB or can shorten CHB recovery time in patients with AIWMI undergoing primary percutaneous coronary intervention (PCI). Between May 2002 and April 2005, a PercuSurge device was utilized in 113 patients (study population, group 1) with AIWMI due to obstruction of the right coronary artery (RCA) with a reference lumen diameter (RLD) ≥ 3.5 mm.The control subjects (group 2) consisted of 119 patients who experienced AIWMI due to RCA obstruction with a RLD ≥ 3.5 mm from May 2000 to April 2002. The combined incidence of new onset of CHB following the interventional procedure was significantly higher in group 2 than in group 1. Additionally, recovery time from CHB to first-degree heart block or normal sinus rhythm was remarkably longer in group 2 than in group 1. Furthermore, the duration of hospitalization in group 2 was significantly longer than in group 1. Multiple stepwise analyses demonstrated that the PercuSurge device was the only independent predictor of preventing new onset of CHB during the procedure. Additionally, this mechanical device along with final TIMI-3 flow and final myocardial blush grade ≥ 2 was independently associated with reducing recovery time from CHB. In conclusion, the PercuSurge device can prevent procedure-related CHB and shorten the recovery time for CHB in patients with AIWMI undergoing primary PCI. (Int Heart J 2007; 48: 35-44)

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“…Both studies [11,12], however, do not mention the time of onset of the A V block. Reports are available that some patients recover from an early AV block (< 6 h) but also develop a late block [13] and that an early block may be a pre dominant manifestation of parasympathetic overactivity [13,14]. Hence, we extended the time limit of an early AV block to a 24-hour period to include all patients with AV block besides those in whom pure vagal overactivity contributes to the AV conduc tion disorder.…”

Section: Discussionmentioning

confidence: 99%

Significance of Early and Late Atrioventricular Block in Patients with a Q Wave Acute Inferior Myocardial Infarction

Jaradah

Bhatnagar

Al-Yusuf

1989

Med Principles Pract

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One hundred and seventeen consecutive patients (mean age 55 years) with Q wave acute inferior myocardial infarction (MI) were studied. Of these, 62 developed atrioventricular (AV) conduction disorders (group I) and 55 did not (group II). The AV block occurred early (within 24 h) in 38 (Ia) and later in 24 patients (Ib). We report the in-hospital morbidity and mortality of these acute MI patients. There were no significant differences between group Ia and Ib patients with respect to coronary artery disease risk factors. Right ventricular MI was diagnosed in 14 (36%) and 7 (29%) group Ia and Ib patients, respectively (p = NS), and in 5 (9%) of group II patients. Mean peak serum creatine kinase was highest in group Ia patients (2,403 IU/1) compared to 1,860 IU/1 in group Ib and 1,369 IU/1 in group II. There was cardiogenic shock in 11 patients with 10 deaths in group Ia, while in group II, 2 patients had cardiogenic shock and 3 died (p < 0.01). Only mortality was significantly higher in group Ia compared to group Ib (p < 0.05). Cardiogenic shock was twice the rate in group Ib (n = 4) compared to group II (n = 2; p < 0.05), but there was no difference in mortality. A complete AV block was present in 32 patients (84 %), with 25 (66 %) requiring a pacemaker in group Ia, compared to 9 (37%), with 8 (33%) requiring a pacemaker, in group Ib (p < 0.01). We conclude that prognosis is poor with the appearance of an AV block ≤ 24 h after Q wave acute inferior MI, although mortality in patients with late AV block ( > 24 h) remains similar to those without this complication. Cardiogenic shock may be higher in patients with AV block ≤ 24 h.

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Early and late atrioventricular block in acute inferior myocardial infarction

Cited by 111 publications

References 14 publications

Inferior myocardial infarction. High-risk subgroups.

Inferior myocardial infarction. High-risk subgroups.

Impact of PercuSurge GuardWire Device on Prevention and Reduction of Recovery Time From Complete Heart Block in Patients With Acute Inferior Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Significance of Early and Late Atrioventricular Block in Patients with a Q Wave Acute Inferior Myocardial Infarction

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