title: Primary percutaneous coronary intervention ameliorates complete atrioventricular block complicating acute inferior myocardial infarction.
abstract: OBJECTIVE
  Complete atrioventricular block (CAVB) in acute inferior ST-segment elevation myocardial infarction (STEMI) is associated with poor clinical outcomes after noninvasive treatment. This study was designed to determine the effect of primary percutaneous coronary intervention (PCI) in patients with CAVB complicating acute inferior STEMI, at a single center.
  
  
  METHODS
  We enrolled 138 consecutive patients diagnosed with STEMI involving the inferior wall; of these, 27 patients had CAVB. All patients received primary PCI. The clinical characteristics, procedural data, and clinical outcomes were compared in patients with versus without CAVB.
  
  
  RESULTS
  Baseline clinical characteristics were similar between patients with and without CAVB. Patients with CAVB were more likely to present with cardiogenic shock, and CAVB was caused primarily by right coronary artery occlusion. Door-to-balloon time was similar between those two groups. After primary PCI, CAVB was reversed in all patients. The peak creatinine phosphokinase level, left ventricular ejection fraction and in-hospital mortality rate were similar between the two groups. After a median follow up of 318 days, major adverse cardiac events did not differ between the groups (8.1% in patients without CAVB; 11.1% in patients with CAVB) (P=0.702).
  
  
  CONCLUSIONS
  We conclude that primary PCI can ameliorate CAVB-complicated acute inferior STEMI, with an acceptable rate of major adverse cardiac events, and suggest that primary PCI should be the preferred reperfusion therapy in patients with CAVB complicating acute inferior myocardial infarction.
authors.affiliation: Department of Internal Medicine, St Vincent's Hospital, The Catholic University of Korea, Suwon, South Korea.
authors.forename: Su Nam
authors.initials: SN
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, St Vincent's Hospital, The Catholic University of Korea, Suwon, South Korea.
authors.forename: You-Mi
authors.initials: YM
authors.lastname: Hwang
authors.affiliation: Department of Internal Medicine, St Vincent's Hospital, The Catholic University of Korea, Suwon, South Korea.
authors.forename: Gee-Hee
authors.initials: GH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, St Vincent's Hospital, The Catholic University of Korea, Suwon, South Korea.
authors.forename: Ji-Hoon
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, St Vincent's Hospital, The Catholic University of Korea, Suwon, South Korea.
authors.forename: Ki-Dong
authors.initials: KD
authors.lastname: Yoo
authors.affiliation: Department of Internal Medicine, St Vincent's Hospital, The Catholic University of Korea, Suwon, South Korea.
authors.forename: Chul-Min
authors.initials: CM
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, St Vincent's Hospital, The Catholic University of Korea, Suwon, South Korea.
authors.forename: Keon-Woong
authors.initials: KW
authors.lastname: Moon
mesh_terms: D000368:Aged; D054537:Atrioventricular Block / Q000150:complications* / Q000601:surgery*; D015415:Biomarkers; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D006801:Humans; D056989:Inferior Wall Myocardial Infarction / Q000150:complications*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*
chemical_list: D015415:Biomarkers; D008055:Lipids
keywords: PCI-capable hospital; major adverse cardiac events