The Effect of Coronary Revascularization on New-Onset Complete Atrioventricular Block Due to Acute Coronary Syndrome

2009 ◽  
Vol 12 (1) ◽  
pp. E30-E34 ◽  
Author(s):  
Cüneyt Narin ◽  
Ahmet Ozkara ◽  
Ahmet Soylu ◽  
Erdal Ege ◽  
Akif Düzenli ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Atrioventricular Block ◽  
Coronary Revascularization ◽  
Complete Atrioventricular Block ◽  
Coronary Syndrome ◽  
Complete Atrioventricular ◽  
New Onset

scholarly journals Complete atrioventricular block in acute coronary syndrome: prevalence, characterisation and implication on outcome

2017 ◽  
Vol 7 (3) ◽  
pp. 218-223 ◽  
Author(s):  
Silvia Aguiar Rosa ◽  
Ana Teresa Timóteo ◽  
Lurdes Ferreira ◽  
Ramiro Carvalho ◽  
Mario Oliveira ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Atrioventricular Block ◽  
Ventricular Arrhythmias ◽  
Complete Atrioventricular Block ◽  
Coronary Syndrome ◽  
Group 2 ◽  
One Year ◽  
Complete Atrioventricular ◽  
Group 1

Purpose: The aim was to characterise acute coronary syndrome patients with complete atrioventricular block and to assess the effect on outcome. Methods: Patients admitted with acute coronary syndrome were divided according to the presence of complete atrioventricular block: group 1, with complete atrioventricular block; group 2, without complete atrioventricular block. Clinical, electrocardiographic and echocardiographic characteristics and prognosis during one year follow-up were compared between the groups. Results: Among 4799 acute coronary syndrome patients admitted during the study period, 91 (1.9%) presented with complete atrioventricular block. At presentation, group 1 patients presented with lower systolic blood pressure, higher Killip class and incidence of syncope. In group 1, 86.8% presented with ST-segment elevation myocardial infarction (STEMI), and inferior STEMI was verified in 79.1% of patients in group 1 compared with 21.9% in group 2 ( P<0.001). Right ventricular myocardial infarction was more frequent in group 1 (3.3% vs. 0.2%; P<0.001). Among patients who underwent fibrinolysis complete atrioventricular block was observed in 7.3% in contrast to 2.5% in patients submitted to primary percutaneous coronary intervention ( P<0.001). During hospitalisation group 1 had worse outcomes, with a higher incidence of cardiogenic shock (33.0% vs. 4.5%; P<0.001), ventricular arrhythmias (17.6% vs. 3.6%; P<0.001) and the need for invasive mechanical ventilation (25.3% vs. 5.1%; P<0.001). After a propensity score analysis, in a multivariate regression model, complete atrioventricular block was an independent predictor of hospital mortality (odds ratio 3.671; P=0.045). There was no significant difference in mortality at one-year follow-up between the study groups. Conclusion: Complete atrioventricular block conferred a worse outcome during hospitalisation, including a higher incidence of cardiogenic shock, ventricular arrhythmias and death.

scholarly journals Transient complete atrioventricular block and ST-segment elevation induced by coronary vasospasm due to iatrogenic hyperkalemia: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Miaomiao Cao ◽  
Li Chen ◽  
Chaofeng Sun ◽  
Guoliang Li
Keyword(s):  
Acute Coronary Syndrome ◽  
Atrioventricular Block ◽  
Periodic Paralysis ◽  
Coronary Vasospasm ◽  
Complete Atrioventricular Block ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Normal Urine ◽  
Complete Atrioventricular

Abstract Background Hyperkalemia and acute coronary syndrome are not only all responsible for syncope related to complete atrioventricular block, but also share parts of electrocardiogram manifestations. Additionally, they influence each other. Case presentation A 32-year-old Chinese man presented with severe hypokalemia (1.63 mmol/l) at midnight in the emergency room. He developed unexpected rebound hyperkalemia (7.76 mmol/l) after 18 hours of oral and intravenous potassium chloride supplementation at a concentration of about 10 g/day and a rate of 10 mmol/hour. Subsequently, the patient complained of chest discomfort and dyspnea, followed by syncope for several minutes, approximately 2 hours after potassium reduction treatment had been started. The instant electrocardiogram showed complete atrioventricular block and elevated ST segment in the inferolateral leads, which resolved 15 minutes later, before hyperkalemia was corrected. Combined with mild coronary stenosis and negative myocardial injury markers, transient complete atrioventricular block induced by coronary vasospasm due to iatrogenic hyperkalemia was diagnosed. Normal urine potassium excretion, acid–base state, and other examinations made the diagnosis of hypokalemic periodic paralysis possible. Conclusions Hyperkalemia may provoke acute coronary syndrome, and early coronary angiography is an effective strategy for identifying the direct cause of acute complete atrioventricular block.

scholarly journals Aortic aneurysm with complete atrioventricular block and acute coronary syndrome

2016 ◽  
Vol 9 (1) ◽  
Author(s):  
Moacyr Magno Palmeira ◽  
Hellen Yuki Umemura Ribeiro ◽  
Yan Garcia Lira ◽  
Fernando Octávio Machado Jucá Neto ◽  
Ivone Aline da Silva Rodrigues ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Aortic Aneurysm ◽  
Atrioventricular Block ◽  
Complete Atrioventricular Block ◽  
Coronary Syndrome ◽  
Complete Atrioventricular

scholarly journals What is the prognosis for patients who develop new-onset atrial fibrillation in the first 48 hours after an acute coronary syndrome?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
I Campos ◽  
C Oliveira ◽  
P Medeiros ◽  
C Marques Pires ◽  
R Flores ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Acute Coronary Syndrome ◽  
Multivariate Analysis ◽  
Mitral Regurgitation ◽  
Coronary Revascularization ◽  
Clinical Manifestations ◽  
Killip Class ◽  
Coronary Syndrome ◽  
Group 1 ◽  
New Onset

Abstract   Atrial fibrillation (AF) is a common complication in acute coronary syndrome (ACS). However, treating patients (pts) with new-onset AF (NOAF) after an ACS remains a challenge. Although it seems intuitive that pts who develop AF within the first 48h have increased morbidity and mortality, your prognosis is unclear because there are no robust studies in the literature to confirm this association. Aim To characterize the population of pts who developed NOAF in the first 48 hours after an ACS and to compare the prognosis between these pts and pts who didn't develop AF. Methods 2916 ACS pts admitted consecutively in our coronary care unit during 6 years were analyzed retrospectively. Of these pts, 343 (11.7%) had AF within the first 48h, of which 99 (3.4%) had pre-existing AF and 243 (8.3%) presented NOAF. Pts were divided into two groups: group 1 -ACS pts who developed NOAF in the first 48h (n=243; 8.8%); group 2 – ACS pts who did not develop AF (n=2517; 91.2%). Pts with pre-existing AF were excluded (n=156; 5.4%). Primary endpoint were the occurrence of death at 6 months; follow-up was completed in 95.8% of pts. Results Group 1 pts were older (72±12 vs 62±13, p&lt;0.001), with higher proportion of women (30,9% vs 20,9%, p&lt;0.001), hypertensive (78,5% vs 60,7%, p&lt;0.001), smokers (17,4% vs 32,6%, p&lt;0.001), previous CABG (7,9% vs 3,8%, p=0.06) and stroke (10,7% vs 6,8%, p=0.035). Group 1 had a higher proportion of STEMI pts (58,5% vs 46,5%, p&lt;0.001) and, during hospitalization, had more often respiratory infection (p&lt;0.001), malignant arrhythmias (p&lt;0.001), heart failure (p&lt;0.001), stroke (p=0.001), higher values of NT-proBNP (p&lt;0.001) increased C-reactive protein levels (p&lt;0.001), leukocytes (p=0.020), peak of TropI (p=0.029) and creatinine (p&lt;0.001). On echocardiography, group1 had greater LA diameter (45±6 VS 41±5mm, p&lt;0.001), more frequent significant mitral regurgitation (13,9% vs 2,9%, p&lt;0.001), worst LVEF (41±10% vs 46±10%, p&lt;0.001) and a higher value of pulmonary artery pressure (39±12 vs 24±10, p&lt;0.001). Group 1 were less likely to have undergone coronary revascularization (84% vs 74%, p=0.005). In multivariate analysis, age ≥75 (OR 1.05, p&lt;0.001), LVEF ≤40% (OR 2.50, p&lt;0.001), LA diameter (OR 1.59, p=0.027), more significant mitral regurgitation (OR 2.49, p=0.001) and Killip class &gt;1 (OR 1.51, p=0.015) remained independent predictors of NOAF. In multivariate analysis and after adjusting for different baseline characteristics, pts with NOAF have the same risk of 6-months mortality compared to those who didn't develop AF [OR 1.03, p=0.91]. Conclusion The incidence of NOAF was 8.8% in our population, which is similar to the literature. Age, LVEF, LA diameter, a significant mitral regurgitation and Killip class &gt;1 were independent predictors of NOAF after ACS. Pts with NOAF in the first 48h after an ACS had worse clinical manifestations during hospitalization but no higher 6-months mortality risk. Funding Acknowledgement Type of funding source: None

The Association Between Cardio-Ankle Vascular Index and Primary Idiopathic Complete Atrioventricular Block in an Elderly Population

Angiology ◽  
2021 ◽  
pp. 000331972110287
Author(s):  
Turhan Turan ◽  
Faruk Kara ◽  
Selim Kul ◽  
Muhammet Rasit Sayın ◽  
Sinan Sahin ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Atrioventricular Block ◽  
Elderly Population ◽  
Complete Atrioventricular Block ◽  
Age Related ◽  
And Gender ◽  
The Relationship ◽  
Block Frequency ◽  
Complete Atrioventricular ◽  
Relevant Factors

The most common cause of complete atrioventricular block (CAVB) is age-related fibrotic degeneration and is referred to as primary idiopathic complete atrioventricular block (iCAVB). This study aims to investigate the relationship between iCAVB and arterial stiffness using the cardio-ankle vascular index (CAVI). In this study, of 205 CAVB patients, 41 patients with iCAVB implanted with a dual-chamber permanent pacemaker and 40 age- and gender-matched controls were studied. Arterial stiffness was assessed by a VaSera VS-1000 CAVI instrument. The CAVI values of patients with iCAVB were significantly higher compared with the controls (9.63 ± 1.42 vs 8.57 ± 1.12, P < .001). Idiopathic complete atrioventricular block frequency was higher among patients with abnormal CAVI values than those with borderline and normal CAVI ( P = .04). In multivariate analysis, only CAVI was an independent predictor of iCAVB after adjusting for other relevant factors (odds ratio, 2.575; 95% CI [1.390-4.770]; P = .003). The present study demonstrated that CAVI, as a marker of arterial stiffness, was increased among elderly patients with iCAVB. Thus, we provide a possible additional mechanism linking easily measured CAVI with iCAVB.

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