What question did this study set out to answer?

October 1, 1972CirculationOpen Access

Clinical and Anatomic Implications of Intraventricular Conduction Blocks in Acute Myocardial Infarction

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Why the study?

Does the presence of intraventricular conduction blocks predict progression to high-grade A-V block and mortality in patients with acute myocardial infarction?

Population

480 patients with acute myocardial infarction

Comparison

Presence of intraventricular conduction blocks vs No evidence of intraventricular conduction…

Design

Cohort

Authors

MSMelvin M. ScheinmanElectrophysiology BBB. BRENMANSan Francisco General Hospital

Discussion

Member takes

Implication

May support selective pacing consideration only with concomitant 1° AV block in AMI; leaves open routine prophylactic benefit.

Key Points

To investigate the clinical and anatomic implications of intraventricular conduction blocks in patients with acute myocardial infarction.
Analyzed electrocardiograms from 480 patients with acute myocardial infarction.
Assessed types of conduction blocks and their association with clinical outcomes.
Evaluated progression to high-grade A-V block in patients with and without 1° A-V block.
Incidence of 1° A-V block in patients with I-V block was 18.6%, with 39% progression to high-grade A-V block.
Patients with intraventricular conduction block had a 92% incidence of death due to cardiac failure or shock.
Intraventricular conduction block implies a hectic clinical course, but does not recommend routine pacing, except in patients with 1° A-V block.

Structured PICO

Does the presence of intraventricular conduction blocks predict progression to high-grade A-V block and mortality in patients with acute myocardial infarction?

Population

480 patients with acute myocardial infarction

Intervention

Presence of intraventricular conduction (I-V) blocks (e.g., RBBB, LBBB, LAH, LPH)

Comparator

No evidence of intraventricular conduction disturbance

Outcome

Progression to high-grade A-V block, complete heart block, and cause of deathhard clinical

The presence of intraventricular conduction blocks in acute myocardial infarction implies a poor prognosis but does not justify prophylactic temporary pacing unless associated with first-degree A-V block.

Cite This Study

Scheinman et al. (1972) studied this question.

synapsesocial.com/papers/6a709de4e36a167817e26dc1 https://doi.org/10.1161/01.cir.46.4.753

Topics

Heart failure HFrEF treatment

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Clinical and Anatomic Implications of Intraventricular Conduction Blocks in Acute Myocardial Infarction

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Clinical and Anatomic Implications of Intraventricular Conduction Blocks in Acute Myocardial Infarction

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider