Atrioventricular and Intraventricular Conduction Disorders in Acute Myocardial Infarction: A Reappraisal in the Thrombolytic Era

Simons, Grant R.; Sgarbossa, Elena B.; Wagner, Galen S.; Califf, Robert M.; Topol, Eric J.; Natale, Andrea

doi:10.1111/j.1540-8159.1998.tb00042.x

Cited by 48 publications

(25 citation statements)

References 67 publications

(4 reference statements)

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“…7 Similar associations were obtained in smaller reports after the advances in thrombolytic therapy. 9,16,20 These findings are also in concordance with coronary distribution.…”

Section: Clinical Investigations Continuedsupporting

confidence: 71%

“…While the right coronary artery supplies the AV node in 90% of individuals, the left ventricle is supplied by both the right and left coronary systems. 7 In this study, we analyzed a nationally representative hospital discharge database to evaluate the relationship between the location of AMI and the associated arrhythmias and conduction abnormalities. In addition, we investigated the impact of these arrhythmias on in-hospital mortality following AMI.…”

Section: Introductionmentioning

confidence: 99%

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Location of Acute Myocardial Infarction and Associated Arrhythmias and Outcome

Hreybe

Saba

2009

Clinical Cardiology

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BackgroundCardiac arrhythmias and conduction abnormalities complicating acute myocardial infarction (AMI) have been associated with adverse prognosis in numerous reports. Small studies have frequently associated different arrhythmias with various distributions of myocardial infarctions. We analyzed a nationally representative hospital discharge database to evaluate the relationship between the location of AMI and the associated arrhythmias and conduction abnormalities and their impact on in‐hospital mortality.MethodsWe searched the National Hospital Discharge Survey database for patients with a diagnosis of AMI and collected data on the associated arrhythmias and conduction abnormalities. In‐hospital death was used as end point for analysis.ResultsA total of 21,807 patients, representing 2,632,217 hospital discharges in the United States, with a primary diagnosis of AMI from 1996 to 2003 were included in this analysis. Patients with inferior or posterior AMI were more likely to develop complete heart block compared to those with anterior or lateral AMI (3.7% vs 1.0%, hazard ratio [HR] = 3.9, p ≤ 0.001), but less likely to die prior to hospital discharge (7.7% vs 11.3%, HR = 0.65, p ≤ 0.001).ConclusionsPatients with an inferior or posterior AMI are more likely to develop conduction system abnormalities when compared to patients with an anterior or lateral AMI. On the other hand, anterior or lateral MI is a significant predictor of in‐hospital death. Copyright © 2009 Wiley Periodicals, Inc.

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“…7 Similar associations were obtained in smaller reports after the advances in thrombolytic therapy. 9,16,20 These findings are also in concordance with coronary distribution.…”

Section: Clinical Investigations Continuedsupporting

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Location of Acute Myocardial Infarction and Associated Arrhythmias and Outcome

Hreybe

Saba

2009

Clinical Cardiology

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“…PCI, percutaneous coronary intervention; CAVB, complete atrioventricular block; LVEDP, left ventricular end-diastolic pressure; STEMI, ST-segment elevation myocardial infarction; RCA, right coronary artery; RPDA, right posterior descending artery; LAD, left anterior descending artery. many collaterals, and the capability of nutrients and oxygen absorption by diffusion from the surrounding venous sinusoids [18]. In the thrombolytic era, it was shown that thrombolytic therapy had a paradoxical effect on the conduction system and it had the potential to precipitate conduction abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Frequency of Complete Atrioventricular Block Complicating ST-Elevation Myocardial Infarction in Patients Undergoing Primary Percutaneous Coronary Intervention

Chera¹,

Mitre²,

Nealis³

et al. 2018

Cardiology

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Objectives: ST-segment elevation myocardial infarction (STEMI) can be associated with many conduction disturbances including complete atrioventricular block (CAVB). CAVB complicating STEMI resulted in an increased mortality before the modern era of primary percutaneous coronary intervention (PCI). The aim of this study was to ascertain the rate and risk factors for CAVB in STEMI patients undergoing rapid reperfusion with PCI. Methods: We analyzed 223 patients presenting with STEMI. Patient characteristics, procedural characteristics, and in-hospital data were compared between patients with and without CAVB. Results: Out of 223 patients, 174 underwent PCI; the majority (87%) was African-American. CAVB was present in 8 patients (4.6%), and 6 of them had RCA occlusion. Independent predictors of CAVB included diabetes mellitus, female gender, lower systolic and diastolic blood pressure, and inferior-lateral/lateral STEMI. Ten patients (5.7%) required temporary pacing at presentation; only 1 patient required permanent pacing before discharge. No patient with anterior STEMI developed CAVB. Conclusions: The incidence and in-hospital mortality rate of CAVB in patients with STEMI who underwent primary PCI was reduced when compared to data from the thrombolytic era. This may be due to faster flow recovery in the infarct-related artery achieved with PCI.

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“…9 In the thrombolytic era, it was shown that thrombolytic therapy may paradoxically precipitate the development of AVB. 10 It was suggested that the reperfusion of the obstructed coronary artery induces a surge of afferent vagal activity that in turn induced a Atrioventricular Block.…”

Section: Discussionmentioning

confidence: 99%

Study of Prognosis of Atrioventricular Blocks Versus Intraventricular Blocks in Acute Myocardial Infarction

Reddy¹,

Prasad²,

Prabhakar³

et al. 2016

jemds

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Myocardial infarction is a Global epidemic, and it is as large as the new epidemic afflicting population worldwide. According to the National Commission on Macro-economics and Health, there would be around 62 million patients with Coronary Artery Disease (CAD) by 2015 in India, and of these, 23 million would be younger than 40 years of age. 1 The present study will enlighten the correlation of Atrioventricular conduction defects versus intraventricular conduction defects in acute myocardial infarction after thrombolytic era. AIMS AND OBJECTIVESTo study the prognosis of atrioventricular conduction blocks versus intraventricular conduction defects in patients with acute myocardial infarction. MATERIALS AND METHODSIt is a prospective and comparative cohort study; 72 patients admitted in RLJH diagnosed as acute myocardial infarction who are with AV conduction blocks and myocardial infarction with intraventricular conduction blocks are included in the study. That is 36 patients with acute myocardial infarction with atrioventricular conduction blocks compared with 36 patients of myocardial infarction with intraventricular conduction blocks. Seven days followup is done to assess the prognosis of AV blocks versus intraventricular conduction blocks in acute myocardial infarction. RESULTSBoth AV (75%) and intraventricular (80%) blocks (IV blocks) are more in males, but no significant difference between AV and IV blocks with respect to gender. Chest pain (86%) is the common presentation for conduction disturbances in acute Myocardial Infarction (MI). Breathlessness is more specific for intraventricular blocks in acute MI. Anterior wall (52.8%) is involved in intraventricular conduction blocks compared to AV Blocks (27.8%). Inferior wall (55.6%) is involved in AV blocks more than anterior Wall (41.7%). In Killips staging most of AV blocks presented in stage 3 compared to IV block which have less risk (Stage 1) and better prognosis. Based on mortality AV blocks have more mortality of 33.3% compared to Intraventricular blocks (8.3%) in acute Myocardial Infarction (MI). CONCLUSIONHence taking all things together AV blocks are associated with greater risk or poor prognosis compared to intraventricular blocks in acute myocardial infarction according to this present study. A cross sectional study of the nutrient intake of rural Adolescent girls was carried out in four villages

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Atrioventricular and Intraventricular Conduction Disorders in Acute Myocardial Infarction: A Reappraisal in the Thrombolytic Era

Cited by 48 publications

References 67 publications

Location of Acute Myocardial Infarction and Associated Arrhythmias and Outcome

Location of Acute Myocardial Infarction and Associated Arrhythmias and Outcome

Frequency of Complete Atrioventricular Block Complicating ST-Elevation Myocardial Infarction in Patients Undergoing Primary Percutaneous Coronary Intervention

Study of Prognosis of Atrioventricular Blocks Versus Intraventricular Blocks in Acute Myocardial Infarction

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