Reversibility of Atrioventricular Block According to Coronary Artery Disease: Results of a Retrospective Study

Hwang, In‐Chang; Seo, Won‐Woo; Oh, Il-Young; Choi, Eue Keun; Oh, Seil

doi:10.4070/kcj.2012.42.12.816

Cited by 18 publications

(15 citation statements)

References 17 publications

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“…There is an increased risk for the development of complete AV block in patients suffering from STEMI as compared to patient’s non-STEMI [9, 10]. The exact mechanism for the development of complete AV block still remains unclear.…”

Section: Resultsmentioning

confidence: 99%

Atrioventricular block after acute myocardial infarction and its association with other clinical parameters in Pakistani patients: an institutional perspective

et al. 2018

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ObjectivesConduction defects complicating acute myocardial infarction are frequently associated with increased morbidity and mortality. As frequency of this complication has not been widely studied in our population, therefore in this study we aimed to evaluate the frequency of complete atrioventricular block in patients with acute ST segment elevation myocardial infarction and its association with other clinical parameters.ResultsThe mean age of the patients was 50.55 ± 6.72 years at the time of MI. There were 147 (82.1%) males and 32 (17.9%) females. There were 83 (46.4%) patients having hypertension, 61 (34.1%) diabetes mellitus, 75 (41.9%) smokers, 75 (41.9%) patients having positive family history, 11 (6.1%) having dyslipidemia, and 73 (40.8%) obese patients in this study. The Frequency of complete atrioventricular (AV) block in acute ST segment elevation myocardial infarction was found to be 7.3%, and no association with any other clinical factor was found which could predict this condition according to results of our study. Therefore, protocols should be designed in our routine clinical practice to deal with such a life threatening condition.

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Section: Resultsmentioning

confidence: 99%

Atrioventricular block after acute myocardial infarction and its association with other clinical parameters in Pakistani patients: an institutional perspective

et al. 2018

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“… 9 In these previous studies, the main treatment was thrombolysis or medical treatment, not the primary PCI, and they did not compare the procedural and angiographic data, while in our study, all patients received primary PCI, and procedural and angiographic data were compared in patients with versus without CAVB. Even though successful treatment of inferior AMI presenting with CAVB by reperfusion therapy has been reported frequently in the primary PCI era, 8 – 10 , 15 , 16 whether primary PCI could improve the outcome in patients with acute inferior STEMI presenting with CAVB has not been determined. In our study, all patients received primary PCI (median door-to-balloon time 80.5 minutes [61.75, 107.8, range] minutes); as a result, the mortality rates and major adverse cardiac events were not different independent of CAVB.…”

Section: Discussionmentioning

confidence: 99%

Primary percutaneous coronary intervention ameliorates complete atrioventricular block complicating acute inferior myocardial infarction

Lee

Hwang

Kim

et al. 2014

CIA

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ObjectiveComplete atrioventricular block (CAVB) in acute inferior ST-segment elevation myocardial infarction (STEMI) is associated with poor clinical outcomes after noninvasive treatment. This study was designed to determine the effect of primary percutaneous coronary intervention (PCI) in patients with CAVB complicating acute inferior STEMI, at a single center.MethodsWe enrolled 138 consecutive patients diagnosed with STEMI involving the inferior wall; of these, 27 patients had CAVB. All patients received primary PCI. The clinical characteristics, procedural data, and clinical outcomes were compared in patients with versus without CAVB.ResultsBaseline clinical characteristics were similar between patients with and without CAVB. Patients with CAVB were more likely to present with cardiogenic shock, and CAVB was caused primarily by right coronary artery occlusion. Door-to-balloon time was similar between those two groups. After primary PCI, CAVB was reversed in all patients. The peak creatinine phosphokinase level, left ventricular ejection fraction and in-hospital mortality rate were similar between the two groups. After a median follow up of 318 days, major adverse cardiac events did not differ between the groups (8.1% in patients without CAVB; 11.1% in patients with CAVB) (P=0.702).ConclusionWe conclude that primary PCI can ameliorate CAVB-complicated acute inferior STEMI, with an acceptable rate of major adverse cardiac events, and suggest that primary PCI should be the preferred reperfusion therapy in patients with CAVB complicating acute inferior myocardial infarction.

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“…The culprit lesion was located in the RCA in 14 of the 15 acute MI patients. Conversely, only 1 of the 43 patients (2.3%) with stable angina and none of the 2 patients with unstable angina reverted to 1 : 1 AV conduction after revascularization, despite the fact that roughly 60% (26/43) of these patients also had significant RCA lesions [ 48 ].…”

Section: Theoretical Mechanisms Of Av Block Reversibility In Coronmentioning

confidence: 99%

Reversibility of High-Grade Atrioventricular Block with Revascularization in Coronary Artery Disease without Infarction: A Literature Review

Cardoso

Alfonso

Coffey

2016

Case Reports in Cardiology

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Complete atrioventricular (AV) block is known to be reversible in some cases of acute inferior wall myocardial infarction (MI). The reversibility of high-grade AV block in non-MI coronary artery disease (CAD), however, is rarely described in the literature. Herein we perform a literature review to assess what is known about the reversibility of high-grade AV block after right coronary artery revascularization in CAD patients who present without an acute MI. To illustrate this phenomenon we describe a case of 2 : 1 AV block associated with unstable angina, in which revascularization resulted in immediate and durable restoration of 1 : 1 AV conduction, thereby obviating the need for permanent pacemaker implantation. The literature review suggests two possible explanations: a vagally mediated response or a mechanism dependent on conduction system ischemia. Due to the limited understanding of AV block reversibility following revascularization in non-acute MI presentations, it remains difficult to reliably predict which patients presenting with high-grade AV block in the absence of MI may have the potential to avoid permanent pacemaker implantation via coronary revascularization. We thus offer this review as a potential starting point for the approach to such patients.

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Reversibility of Atrioventricular Block According to Coronary Artery Disease: Results of a Retrospective Study

Cited by 18 publications

References 17 publications

Atrioventricular block after acute myocardial infarction and its association with other clinical parameters in Pakistani patients: an institutional perspective

Atrioventricular block after acute myocardial infarction and its association with other clinical parameters in Pakistani patients: an institutional perspective

Primary percutaneous coronary intervention ameliorates complete atrioventricular block complicating acute inferior myocardial infarction

Reversibility of High-Grade Atrioventricular Block with Revascularization in Coronary Artery Disease without Infarction: A Literature Review

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