Risk markers of late high-degree atrioventricular block in patients with left ventricular dysfunction after an acute myocardial infarction: a CARISMA substudy

Aims High-degree atrioventricular block (HAVB) after acute myocardial infarction (AMI) is associated with increased risk of mortality. Risk markers and predictors of HAVB occurring after AMI are largely unknown. The aim of this study was to assess the predictive value of risk markers derived from a...

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Bibliographic Details
Published in:Europace (London, England) England), 2011-10, Vol.13 (10), p.1471-1477
Main Authors: Gang, Uffe Jakob Ortved, Jøns, Christian, Jørgensen, Rikke Mørch, Abildstrøm, Steen Zabell, Messier, Marc D., Haarbo, Jens, Huikuri, Heikki V., Thomsen, Poul Erik Bloch
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Atrioventricular Block - diagnosis
Atrioventricular Block - epidemiology
Atrioventricular Block - physiopathology
Electrocardiography, Ambulatory
Female
Follow-Up Studies
Heart Rate - physiology
Humans
Incidence
Kaplan-Meier Estimate
Male
Myocardial Infarction - complications
Predictive Value of Tests
Prospective Studies
Risk Factors
Tachycardia, Ventricular - diagnosis
Tachycardia, Ventricular - physiopathology
Ventricular Dysfunction, Left - etiology
Ventricular Dysfunction, Left - physiopathology
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Summary:Aims High-degree atrioventricular block (HAVB) after acute myocardial infarction (AMI) is associated with increased risk of mortality. Risk markers and predictors of HAVB occurring after AMI are largely unknown. The aim of this study was to assess the predictive value of risk markers derived from a series of non-invasive and invasive tests for the development of HAVB documented by an implantable loop recorder (ILR) in late convalescent phases of an AMI. Methods and results The study included 292 patients with AMI and subsequent left ventricular dysfunction without prior HAVB or implanted pacemaker. An ILR was implanted for continuous arrhythmia surveillance. Risk stratification testing was performed at inclusion and 6 weeks after AMI. The tests included echocardiography, electrocardiogram (ECG), 24 h Holter monitoring, and an invasive electrophysiological study. High-degree atrioventricular block was documented in 28 (10%) patients during a median follow-up of 2.0 (0.4-2.0) years. Heart rate variability (HRV) measures and non-sustained ventricular tachycardia occurring at the week 6 Holter monitoring were highly predictive of HAVB. Power law slope
ISSN:1099-5129
1532-2092
DOI:10.1093/europace/eur165