CAUSES, CLINICAL CHARACTERISTICS AND HOSPITAL OUTCOMES OF PATIENTS WITH HIGH DEGREE AV BLOCKS

Abstract

Objective: To evaluate the causes, symptoms, clinical course and outcome of
patients admitted to Cardiology department with high degree AV blocks
Methodology: All patients admitted to Cardiology unit with high degree AV blocks
st st from 1 January 2012 to 31 May 2012 were included in the study. Baseline
clinical characteristics, causes, signs and symptoms, management strategies
and outcomes were recorded on a pre-designed Performa. Statistical analysis
was done using SPSS version 19.
Results: A total of 127 patients were included in the study. Males were 55(43.3%)
and 72(56.7%) were females mean age was 65 ±13.73 years and mean heart
rate at presentation was 36±4.32 were (95(74.81%) patients having aged more
than 50 years). Total 83(65.35%) were hypertensive and 55(43.30%) were
diabetics. The causes found were coronary artery disease in 43(33.9%), beta
blockers in 32(25.19%), rate limiting calcium channel blockers in 8(6.9%),
digoxin in 3(2.3%), Hyperkalemia (K+>5.5 mq/l) in 11 (8.66%), deranged urea
(>50 mg/dl) in 45(35.43%), Increased creatinine in 26(20.46%) patients. While
no cause was found in 69(54.33%) patients. The symptoms including
dizziness/vertigo found in 102 (80.31%), Presyncopae in 95(74.80%), syncope
in 64(50.39%), fits in 5(3.93%) and dyspnea in 45(35.43%). Among them 22
(17.32%) patients responded to Atropine. were 105(82.68%) patients required
TPM (Temporary Pacemaker). Of these 105 patients, 43 patients required
permanent pacemaker (PPM). patients died were 4(3.1%)
Conclusion: Most patients were aged more than 50 years, The common causes
of block were ischemic and degenerative heart diseases. Presenting symptoms
were vertigo, dizziness, presyncope, syncopal attacks and dyspnea. A quarter of
patients responded to atropine, of remaining half required permanent pacemaker.