Impact of Primary Percutaneous Coronary Intervention on Complete Atrioventricular Block With Acute Inferior ST-Elevation Myocardial Infarction

Abstract

Background and aims Complete atrioventricular block (CAVB) is associated with poor clinical outcomes in ST-elevation myocardial infarction (STEMI). This study determined the frequency and outcomes of primary percutaneous coronary intervention (PPCI) in patients with CAVB with acute inferior STEMI. Methods We conducted an observational, prospective study and enrolled 151 patients who were diagnosed with inferior STEMI. All patients received PPCI. The clinical outcomes were compared in patients with and without CAVB. The data was recorded on a collection form and analyzed on Statistical Package for Social Sciences (SPSS) software. Descriptive statistics were applied. For quantitative variables, standard deviation and mean were obtained, and statistical tests were also applied. Results Baseline characteristics were homogeneous in all patients. Half of the study population was either diabetic or hypertensive. Out of 151 participants, 21 (13.9%) developed CAVB. Two-thirds of the patients, who had developed heart block, reverted after PPCI. After a follow-up of two weeks, in-hospital mortality did not differ between the groups. Conclusion We conclude that PPCI can improve outcomes of CAVB-complicated acute inferior STEMI and suggest that primary PCI should be the preferred reperfusion therapy in patients with CAVB with STEMI.

Predictors of pacemaker implantation in patients with myocardial infarction and heart block

“…Несмотря на существенный прогресс высокотехнологических методов реваскуляризации миокарда, блокады сердца, ассоциированные с ИМ, являясь главным электрофизиологическим паттерном внезапной сердечной смерти, ухудшают ближайший и отдаленный прогноз. Успешная реперфузия, уменьшая степень и выраженность необратимых изменений в проводящей системе сердца, способствует восстановлению атриовентрикулярного проведения [8], и двукратно снижает риск внезапной сердечной смерти [9]. Тем не менее, по истечении времени вследствие хронической коронарной недостаточности и прогрессирования дегенеративных изменений в проводящей системе сердца блокады рецидивируют и требуют постоянной хронотропной поддержки, осуществляемой с помощью постоянной ЭКС.…”

Develop a risk stratification model and clinical analysis to predict the impact of primary percutaneous coronary intervention on complete AV block in acute inferior STEMI patients

“…Therefore, a thorough risk-benefit analysis is required for every patient. PCI continues to play key role in treating STEMI, and efforts to improve its accessibility and safety are crucial in the battle against cardiovascular disease 14 .…”