Can Revascularization Restore Sinus Rhythm in Patients with Acute Onset Atrioventricular Block?

Abstract Background: We studied patients with coronary artery disease (CAD) and complete atrioventricular (AV) block of acute onset that were treated with coronary artery bypass grafting (CABG) to see whether revascularization can restore the sinus rhythm. Methods: CABG was performed on eight patients with newly developed complete AV block and severe CAD. The distribution of coronary artery lesions showed a type IV pattern in six patients and a type II pattern in two patients. Complete revascularization was performed in six patients. Left anterior descending artery was revascularized in all eight patients. The patients were followed-up after operation for approximately 10 days before the implantation of a permanent pacemaker to see if they recover from AV block. Results: The mean interval from development of complete AV block to operation was 3.63 ± 1.3 days. There was no operative and/or early mortality. None of the patients recovered from complete AV block after coronary revascularization. Early morbidity was not detected. The mean hospital stay (12.75 ± 1.49 days) and intensive care unit stay (30.25 ± 19.39 hours) were relatively long because of the delay in permanent pacemaker implantation. All patients were asymptomatic at the end of their follow-up period (23.38 ± 18.41 months). Conclusions: Preoperatively developed complete AV block did not adversely affect the operative and early postoperative outcome of CABG operations. Recovery from complete AV block cannot be achieved by coronary revascularization performed 3.63 ± 1.3 days after the onset of complete AV block.