Atrioventricular block complicating inferior acute myocardial infarction treated with thrombolytic therapy.
OBJECTIVE
To investigate the influence and mechanism of incidence of atrioventricular block (AVB) treated with thrombolytic therapy in acute inferior myocardial infarction (AIMI).


METHODS
A total of 46 patients with AIMI were divided into the thrombolytic group (n = 23) and the non-thrombolytic group (n = 23). Intravenous or intracoronary urokinase was given to the former group. We observed the advancing courses of AVB, and further assessed the relationship between occurrence of AVB and stenosis of infarct-related artery (IRA) with coronary angiography.


RESULTS
Two cases died of III degree AVB in the non-thrombolytic group, but none was found in the thrombolytic group. The occurrence rate of AVB was similar in both groups; but that of III degree AVB was much lower in the thrombolytic group (4 cases) than that in the non-thrombolytic group (11 cases, P < 0.05), and the duration of AVB decreased from 201 +/- 113 hours to 102 +/- 60 hours after thrombolytic therapy (P < 0.01), which was mainly due to the decrease of AVB in the vanishing interval, but not in the developing interval. The coronary angiography demonstrated that there were an increasing reperfusion flow and a decreasing coronary stenosis of the infarct-related artery after thrombolytic therapy.


CONCLUSIONS
Thrombolytic therapy can reduce the incidence of severe AVB, shorten its duration and decrease the mortality by increasing the coronary reperfusion flow in the patients with AIMI.
Chen
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S
Department of Medicine, Center of Gereology, 305th Hospital of People's Liberation Army, Beijing 100017, China.
Feng
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S
Zhang
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Q
D000328:Adult; D000368:Aged; D003326:Coronary Circulation; D005260:Female; D006327:Heart Block / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000503:physiopathology / Q000628:therapy*; D011446:Prospective Studies; D015912:Thrombolytic Therapy; D013997:Time Factors