12. Short Term Hospital Outcome of Atrioventricular (AV) Block in the Setting of Acute Inferior Wall Myocardial Infarction (M.I) Treated by Primary Percutaneous Coronary Intervention (PPCI)
Akram Yousif1, Faisal Qadir1, Sanober Soomro2, Feroz Ali1, Noor Ahmed1 and Muhammad Rahman Khalid3
ABSTRACT
Objective: To assess impact of the Primary Percutaneous Coronary Intervention (PPCI) on the early resolution of AV block in patients presenting with acute inferior STEMI.
Study Design: Analytic study
Place and Duration of Study: This study was conducted at the National Institute of Cardiovascular Diseases (NICVD), Karachi from November 2020 to April 2021.
Materials and Methods: We enrolled 165 patients with acute inferior STEMI who presented with any degree of AV block. All patients received PPCI as an initial therapeutic strategy. Pre-and post-procedure clinical parameters were recorded for 5 days after invasive therapy.
Results: Out of 165 enrolled patients, AV block was more common in the older patients (mean age 60.08 ±10.09 years), in males118 (71.5%), and in 86 (52.1%) patients with multi vessel coronary artery disease. The predominant culprit artery was the right coronary artery in 152 (92.1%) patients. 139 (84.2%) patients had restoration of normal AV conduction at end of 5 days of hospitalization. The average time for reversal of AV block was 51.3± 30.2 hours. 23 (14%) patients had persistent AV block and underwent permanent pacemaker implantation. 3 (1.8%) patients had in-hospital mortality.
Conclusion: PPCI for acute inferior wall STEMI significantly enhances early resolution of AV block. Our study highlights that a significant number of patients had restoration of AV conduction at end of five days following PPCI. We suggest delaying waiting time to at least five days after PPCI, before final consideration of implanting permanent pacemaker in this patient group.
Key Words: A V block, Inferior wall, Infarction, coronary intervention
Citation of article: Yousif A, Qadir F, Soomro S, Ali F, Ahmed N, Khalid MR. Short Term Hospital Outcome of Atrioventricular (AV) Block in the Setting of Acute Inferior Wall Myocardial Infarction (M.I) Treated by Primary Percutaneous Coronary Intervention (PPCI). Med Forum 2022;33(7):50-54.