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

• Published in: Clinical interventions in aging 2014-01, Vol.9, p.2027-2031
• Main Authors: Lee, Su Nam, Hwang, You-Mi, Kim, Gee-Hee, Kim, Ji-Hoon, Yoo, Ki-Dong, Kim, Chul-Min, Moon, Keon-Woong
• Format: Article
• Language: English
• Subjects: Aged; Angioplasty; Atrioventricular Block - complications; Atrioventricular Block - surgery; Biomarkers; Body Mass Index; Cardiovascular disease; Care and treatment; Clinical outcomes; Comorbidity; complete atrioventricular block; Complications and side effects; Coronary vessels; Development and progression; Electrocardiography; Female; Heart attack; Heart attacks; Humans; Inferior Wall Myocardial Infarction - complications; Intervention; Lipids - blood; Male; Medical prognosis; Middle Aged; Mortality; myocardial infarction; Original Research; Patient outcomes; Percutaneous Coronary Intervention - methods; primary percutaneous coronary intervention; Vascular diseases
• ISSN: 1178-1998; 1176-9092; 1178-1998
• DOI: 10.2147/CIA.S74088

Complete 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. We 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. Baseline 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). We 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.