FREQUENCY OF COMPLETE HEART BLOCK AND IN-HOSPITAL MORTALITY IN PATIENTS WITH ACUTE ANTERIOR WALL MYOCARDIAL INFARCTION

Abstract

Objective:To determine the frequency ofcomplete heart block in patients with
acute anterior wall myocardial infarction.

Methodology: Study was conducted from 1 January to 30th June 2011 in the
Cardiology Department of Lady Reading Hospital Peshawar. Patients who
presented with acute anterior wall MI were included in the study. Those patients
who was having renal failure, Hypo or Hyperkalemia, history of valve
replacement, coronary artery bypass graft and those who were using Beta
blocker,Lanoxin and Calcium channel blocker (Verapamil,Diltiazem) were
excluded from the study.
Results:A total of 309 patients were included,out of which 228 (73.8 %) were
male and 81 (26.2 %) were female, having mean age of 58.88 years. A total of 9
patients (2.9 %) developed Complete Heart Block (CHB), 7 were male and 2 were female (p=0.78). Thrombolysis was timely given in 246 (79.6%)
patients.Among the thrombolysed patients, 7 (2.84%) developed CHB whereas 2
(3.17 %) from non thrombolysed group develop CHB (p=0.89).All the patients
who develop CHB were temporarily paced. Out of all patients, 65 (18.1%) died, in whom 44 (17.9%) were thrombolysed and 12 (19.04%) not thrombolysed group (p=.84). Among those who develop high degree Atrioventricular block, 7
(77.77%) patients died.
Conclusion: CHB in anterior wall MI is an uncommon finding in this thrombolytic
era but associated with high incidence of in-hospital death even if these patients
are timely thrombolysed and paced.