Left and right ventricular function in inferior acute myocardial infarction and significance of advanced atrioventricular block

Early Development of High-Degree Atrioventricular Block in Inferior Acute Myocardial Infarction Is Predicted by a J-Point/R-Wave Ratio above 0.5 on Admission

“…High-degree AV block is associated with larger infarct size [2, 5, 8, 11, 12, 13]. In the present study, patients with high-degree AV block tended to have higher peak serum CK levels, however, the difference was not statistically significant.…”

“…In particular, the development of high-degree (second- or third-degree) atrioventricular (AV) block in patients with inferior-wall acute MI is associated with adverse outcome. High-degree AV block, although usually transient, has been associated with up to 20% in-hospital mortality [2, 3, 4, 5]. Increased mortality, higher rates of left-ventricular failure and cardiogenic shock were more prevalent in patients with early (within the first 24 h) than late appearance of high-degree AV block [6].…”

Clinical and angiographic outcome of patients with acute inferior myocardial infarction

“…In line with our data, complete atrioventricular block complicates acute inferior myocardial infarction in 5 to 13 % (32,33), and is present in 13 to 48 % (9, 10, 17) of patients with proximal involvement of the right coronary artery or RVI. While the exact mechanism by which complete atrioventricular block contributes to a commonly reported increased in hospital mortality remains controversial, its occurrence has been linked to a higher incidence of heart failure attributable to larger infarct size (33,34). In our study as well, patients with RVI had larger infarct size as suggested by higher peak lactate-dehydrogenase levels.…”

High-degree atrioventricular block complicating ST segment elevation myocardial infarction in the contemporary era

“…Strasberg et al 21 also showed this association between early blocks and a higher mortality compared with late blocks. Nonetheless, it can be hypothesised that the early time of occurrence of HAVB is not solely responsible for this higher mortality which is probably related to an overall greater severity of STEMI as assessed by the presence of cardiogenic shock on admission in 20–25% of cases and the higher frequency of right ventricular infarction in these subgroups.…”