March 15, 2010Annals of the Academy of Medicine Singapore
Clinical and Angiographic Findings of Complete Atrioventricular Block in Acute Inferior Myocardial Infarction
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Why the study?
Does complete atrioventricular block complicating acute inferior myocardial infarction worsen clinical outcomes compared to no atrioventricular block?
Population
550 consecutive patients admitted with a discharge diagnosis of inferior wall myocardial infarction. The…
Comparison
Development of complete atrioventricular block… vs No atrioventricular block during acute inferior MI
Design
Cohort
Follow-up
mean 47 months
Authors
Discussion
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Implication
Merits heightened in-hospital monitoring in inferior MI with complete AVB; extends prognostic associations but leaves causal impact and interventions open.
Structured PICO
Does complete atrioventricular block complicating acute inferior myocardial infarction worsen clinical outcomes compared to no atrioventricular block?
P
Population
550 consecutive patients admitted with a discharge diagnosis of inferior wall myocardial infarction (MI). The primary comparison was between 70 patients with complete atrioventricular block (AVB) and 319 patients with no AVB.
I
Intervention
Development of complete atrioventricular block (AVB) complicating acute inferior MI
C
Comparator
No atrioventricular block (AVB) during acute inferior MI
O
Outcome
In-hospital mortality and angiographic findings (infarct-related artery and lesion location)hard clinical
Complete AVB complicating acute inferior MI is a marker of larger infarct size and proximal right coronary artery occlusion, leading to higher in-hospital mortality, though hospital survivors do not require long-term permanent pacing.
Limitations
- Observational study subjected to selection and treatment bias
- Small number of patients with complete AVB who underwent angiography
- Reperfusion therapy depended on therapeutic window and could not be randomized
Cite This Study
Jim et al. (2010) studied this question.
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