The effect of coronary revascularization on new-onset complete atrioventricular block due to acute coronary syndrome.
BACKGROUND
Coronary artery disease is one of the most common causes of complete atrioventricular block (AVB) in adults. In this study, we evaluated whether prompt revascularization of the coronary artery occlusion can ameliorate new-onset complete AVB due to acute coronary syndrome (ACS).


METHODS
Five patients (4 men and 1 woman) with a mean age of 69.8+/-7.1 years with diagnosed new-onset complete AVB and proven coronary artery disease were enrolled in the study. At the time of AVB diagnosis, 3 of the patients had acute myocardial infarction, and the other 2 patients had unstable angina pectoris. All patients underwent complete coronary bypass surgery after the diagnosis of complete AVB. A patient who underwent 2 coronary bypasses also underwent aortic valve replacement.


RESULTS
No mortality was observed in the study group. All but one of the patients converted back to sinus rhythm after a mean interval of 30+/-13.6 hours following revascularization procedures. Complete AVB persisted in 1 patient, and a permanent pacemaker was implanted. All patients were discharged uneventfully. The mean hospital stay was 11.4+/-4.5 days. All patients are still being followed up after surgery; at a mean follow-up of 27.4+/-0.9 months, there have been no further problems.


CONCLUSIONS
Coronary revascularization may ameliorate ACS-related new-onset complete AVB with an acceptable rate of successful reversion to sinus rhythm. An especially appropriate time for surgery, complete coronary revascularization, and management of myocardial protection during surgery might improve the results of coronary bypass procedures in these patients.
Narin
Cüneyt
C
Department of Cardiovascular Surgery, Meram Medical School, Selçuk University, Konya, Turkey. cunarin@yahoo.com
Ozkara
Ahmet
A
Soylu
Ahmet
A
Ege
Erdal
E
Düzenli
Akif
A
Sarigül
Ali
A
Yeniterzi
Mehmet
M
D054058:Acute Coronary Syndrome / Q000150:complications* / Q000601:surgery*; D000368:Aged; D054537:Atrioventricular Block / Q000209:etiology* / Q000517:prevention & control*; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000150:complications* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome