Recovery time of atrioventricular conduction and its influencing factors in patients presenting late with inferior wall acute myocardial infarction and atrioventricular block.

OBJECTIVES

To explore the recovery time of atrioventricular conduction and its influencing factors in patients presenting late and diagnosed with inferior wall acute myocardial infarction (AMI) and high-degree atrioventricular block (AVB) on admission.

METHODS

We conducted a retrospective study in patients presenting > 12 h after symptom onset and diagnosed with inferior wall AMI and new onset second-degree type 2 or third-degree AVB on admission. All of them underwent percutaneous coronary intervention (PCI). The clinical characteristics, time to PCI and time to AVB recovery after symptom onset were studied.

RESULTS

Among the 80 patients, 68 were male, aged 63 ± 10 years. The median admission time after symptom onset was 36 h. 10 patients presented with second-degree type 2 AVB and 70 patients with third-degree AVB. The median time of AVB recovery from AMI onset was 5d (Q1-Q3:4-7d; Min-max: 1-15d). Patients were divided into two groups according to the median AVB recovery time. Compared to the late recovery group (> 5 days), patients in the early recovery group (≤ 5 days) had shorter admission time after AMI onset (P < 0.001) and received PCI earlier (P < 0.001). Multivariate Logistic regression analysis showed that admission time from AMI onset (OR:1.032, 95%CI: 1.013-1.052, P = 0.001) and time from AMI onset to PCI (OR: 1.449, 95%CI: 1.163-1.804, P = 0.001) were independent factors for early AVB recovery.

CONCLUSIONS

In patients presenting late with inferior wall AMI complicated with high-degree AVB, the median time of AVB recovery was 5 days. Shorter admission time from AMI onset and earlier PCI treatment were independently associated with earlier AVB recovery.