INCIDENCE AND PROGNOSTIC-SIGNIFICANCE OF COMPLETE HEART-BLOCK COMPLICATING ANTERIOR WALL ACUTE MYOCARDIAL-INFARCTION

The incidence of complete heart block (CHB) among 2,560 consecutive pa tients with acute anterior wall myocardial infarction (MI) was 4% (n = 102). These patients were older, had previous infarction and angina m ore often, and exhibited a higher rate of in-hospital complications th an counterparts without CHB. In-hospital as well as 1- and 10-year pos t-discharge mortality was significantly higher among patients with CHB (75, 31 and 81%) in comparison to counterparts without block (19, 11 and 48%, respectively; p = 0.001 for each). After adjustment for multi ple variables, CHB emerged as an independent predictor of in-hospital death (relative odds 5.7, 95% confidence interval: 3.1-10.4) but not f or subsequent mortality. In view of the very high mortality among pati ents with anterior acute MI exhibiting CHB, high priority should be gi ven to extensive monitoring and aggressive treatment of these patients .