Complete atrioventricular block complicating acute anterior myocardial infarction can be reversed with acute coronary angioplasty.
BACKGROUND
A retrospective case series of acute anterior myocardial infarction (MI) patients complicated by complete atrioventricular block (AVB) treated with acute percutaneous transluminal coronary angioplasty (PTCA).


METHODS
Eight patients with anterior MI and complete AVB underwent acute PTCA between 2000 and 2005. Mean onset of complete AVB was 16.6 +/- 16.9 hours from chest pain onset.


METHODS
All patients underwent successful PTCA to the left anterior descending artery.


RESULTS
Complete AVB resolved with PTCA in 88%; mean time of resolution was 89 +/- 144 minutes after revascularisation. One patient had permanent pacemaker implanted at Day 12 after developing an 8-second ventricular standstill during hospitalisation but not pacing-dependent on follow-up. The rhythm on discharge for the other surviving patients was normal sinus rhythm.


CONCLUSIONS
This case series suggests that complete AVB complicating anterior MI is reversible with acute PTCA and survivors are not at increased risk of recurrent AVB. Nevertheless, this condition is associated with extensive myocardial damage and high mortality during the acute hospitalisation was not improved with correction of AVB with temporary pacing.
Ho
Kay Woon
KW
Department of Cardiology, National Heart Centre Singapore.
Koh
Tian Hai
TH
Wong
Philip
P
Wong
Sung Lung
SL
Lim
Yen Teak
YT
Lim
Soo Teik
ST
Hsu
Li Fern
LF
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D056988:Anterior Wall Myocardial Infarction / Q000150:complications* / Q000628:therapy*; D054537:Atrioventricular Block / Q000150:complications* / Q000628:therapy*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies