scholarly journals Total atrioventricular block in patient with late onset acute inferior myocardial infarction

Author(s):  
Ken Christian Kawilarang ◽  
I. Kadek H. Hermawan ◽  
Febryanti Hartono

TAVB is common complication of acute inferior myocardial infarction (AMI). Total atrioventricular block (TAVB) occurs when none of the impulses are conducted from atrium to ventricles and move independently without coordination. In our case, A 61-year-old woman came to the emergency room (ER) with chief complaint of general weakness and nausea without any other complaints since 4 days before going to ER. She had TAVB which is a complication of undiagnosed AMI due to silent ischemia. She didn't get reperfusion therapy because of patient delay and limited resources. Pharmacological therapy had been given while awaiting implantation of temporary pacemaker (TPM). Two days after insertion, the heart rhythm returned to sinus rhythm, therefore permanent pacemaker implantation was not required. TAVB in AMI usually resolves spontaneously. Therefore, it is important to identify TAVB in AMI, so we can quickly diagnose and promptly treat the patient. Thus, it can reduce mortality and increase the probability of spontaneous resolution of TAVB, so physician practice management (PPM) insertion can be avoided.

2011 ◽  
Vol 44 (2) ◽  
pp. e60
Author(s):  
Elin Trägårdh-Johansson ◽  
Jonas Pettersson ◽  
Galen S. Wagner ◽  
Leif Sörnmo ◽  
Hans Öhlin ◽  
...  

2010 ◽  
Vol 138 (9-10) ◽  
pp. 635-638
Author(s):  
Ivan Stankovic ◽  
Biljana Putnikovic ◽  
Milos Panic ◽  
Alja Vlahovic-Stipac ◽  
Aleksandar Neskovic

Introduction. Pacemaker syndrome consists of the symptoms and signs present in the single chamber (VVI) pacemaker patient with electrode placed in the right ventricular apex. It is caused by inadequate timing of atrial and ventricular contractions. Pacemaker syndrome without a pacemaker (or pseudopacemaker syndrome) refers to occurrence of symptoms in the presence of marked first-degree atrioventricular (AV) block, when P wave is too close to the preceding QRS complex producing the same haemodynamic disturbance as artificial pacemaker cardiac stimulation with retrograde VA conduction. Case Outline. We present the patient with acute inferior myocardial infarction due to late bare metal stent thrombosis, treated with primary pectutaneous coronary intervention. Hospital course was complicated by complete heart block which was treated with temporary pacing. During the stand-by mode of temporary pacing, sinus rhythm with marked first-degree AV block (PQ interval 480 ms) was observed while the patients re-experienced the symptoms that were present prior to pacemaker implantation. Temporary pacing was continued for the next 24 hours when spontaneous shorteninig of PQ interval (250-270 ms) was noticed; since the patient was asymptomatic during the stand-by mode, the pacemaker electrodes were removed and the patient discharged 11 days after admission. Conclusion. Conduction disturbances, such as the varying degrees of AV blocks, are relatively common in acute inferior myocardial infarction. The first degree AV blok is usually asymptomatic and does not require treatment, unless when it is associated with pseudopacemaker syndrome. In that case, temporary pacing provides haemodynamic stability until conduction system recovers.


Sign in / Sign up

Export Citation Format

Share Document