PROGNOSIS OF ACUTE INFERIOR WALL MI;

COMPLICATED BY ATRIOVENTRICULAR BLOCKS.

Abstract

Introduction: Atrioventricular (AV) block is a common complication of acute
Myocardial Infarction (MI). In pre-thrombolytic era, high (second or third degree) AV block
was seen in approximately 5-7% of patients presenting with acute MI. In setting of Inferior MI,
this was even as high as 28%. Although, the advent of thrombolytic therapy has substantially
decreased the mortality associated with acute MI, the incidence of AV block, particularly in the
setting of inferior MI, remains high. AV block in the setting of inferior MI is also associated with
high in-hospital mortality, however, its effect on long-term mortality is uncertain. Objectives: To
compare the in-hospital mortality of acute inferior wall myocardial infarction with and without
complete Atrioventricular block. Settings: Department of Cardiology Faisalabad Institute of
Cardiology, Faisalabad. Duration of Study: Six months From: 01-05-2014 to 30-11-2014. Study
Design: Cohort study. Results: In our study, out of 80 cases(40 in each group) 42.5%(n=17)
in Group-A and 37.5%(n=15) in Group-B were between 20-50 years of age while 57.5%(n=23)
in Group-A and 62.5%(n=25) in Group-B were between 51-70 years of age, mean+sd was
calculated as 52.58+9.83 and 55.43+8.06 years respectively, 40%(n=16) in Group-A and
47.5%(n=19) in Group-B were male while 60%(n=24) in Group-A and 52.5%(n=21) in
Group-B were females, comparison of in-hospital mortality in both groups was done showing
32.5%(n=13) in Group-A and 7.5%(n=3) while 67.5%(n=27) in Group-A and 92.5%(n=37) had
no findings of in-hospital mortality, Relative Risk was calculated as 4.33 while P value:0.005.
Conclusion: We concluded that in-hospital mortality is significantly high in acute inferior wall
myocardial infarction complicated by atrioventricular block.