Can revascularization restore sinus rhythm in patients with acute onset atrioventricular block?
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.
Omeroglu
Suat Nail
SN
Department of Cardiovascular Surgery, Kosuyolu Heart and Research Hospital, Istanbul, Turkey. suatnail@yahoo.com
Ardal
Hasan
H
Erdogan
Hasan Basri
HB
Eren
Ercan
E
Erentuğ
Vedat
V
Balkanay
Mehmet
M
Akinci
Esat
E
Ipek
Gokhan
G
Yakut
Cevat
C
D000208:Acute Disease; D000328:Adult; D000368:Aged; D001146:Arrhythmia, Sinus / Q000503:physiopathology*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D005260:Female; D006327:Heart Block / Q000601:surgery*; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome