EARLY AND LATE ADVANCED ATRIOVENTRICULAR BLACK IN ACUTE INFERIOR MYOCARDIAL-INFARCTION

Background Advanced atrioventricular block is a frequent complication in patients with inferior acute myocardial infarction (AMI); in patien ts in hospital, it often occurs concurrently with other complications and is associated with high mortality, Very little information is avai lable about early and late advanced atrioventricular block in inferior AMI, We hypothesized that the time of appearance of advanced atrioven tricular block characterized by poor response to atropine requiring te mporary pacemaker therapy may affect the prognosis of patients with in ferior AMI. Methods We studied 51 patients with inferior AMI and advan ced atrioventricular block characterized by poor response to atropine requiring temporary pacemaker therapy. According to pre-established el ectrocardiographic criteria and the time of appearance of the advanced atrioventricular block, patients were divided into two groups: an ear ly block group consisting of 30 patients who developed advanced atriov entricular block during the first 24 h of inferior AMI, and a late blo ck group consisting of 21 patients who developed advanced atrioventric ular block after the first 24 h of chest pain. Results The groups were similar regarding age, coronary risk factors, frequency of right vent ricular infarction, QRS score, atrial and ventricular rates, the time of return to first-degree atrioventricular block, cardiac arrhythmias, heart failure and mortality. The early advanced atrioventricular bloc k group included a greater number of men than did the late group (P = 0.017). Conclusion These data suggest that the time of appearance of a dvanced atrioventricular block does not affect the prognosis of hospit al patients with inferior AMI. (C) 1998 Lippincott-Raven Publishers.