Feng Jiahao, Zhang Yiqiong, Fan Xiaojuan
Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, No.277, Yan Ta Xi Road, Xi'an, 710061, Shannxi, P.R. China.
BMC Cardiovasc Disord. 2025 Feb 28;25(1):138. doi: 10.1186/s12872-025-04589-9.
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.
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.
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.
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.
探讨症状出现较晚且入院时诊断为下壁急性心肌梗死（AMI）并伴有高度房室传导阻滞（AVB）患者的房室传导恢复时间及其影响因素。
我们对症状出现超过12小时且入院时诊断为下壁AMI并新发二度2型或三度AVB的患者进行了一项回顾性研究。所有患者均接受了经皮冠状动脉介入治疗（PCI）。研究了他们的临床特征、症状出现至PCI的时间以及症状出现至AVB恢复的时间。
80例患者中，男性68例，年龄63±10岁。症状出现后的中位入院时间为36小时。10例患者为二度2型AVB，70例患者为三度AVB。从AMI发作到AVB恢复的中位时间为5天（第一四分位数-第三四分位数：4-7天；最小值-最大值：1-15天）。根据AVB恢复时间的中位数将患者分为两组。与恢复较晚组（>5天）相比，恢复较早组（≤5天）的患者在AMI发作后的入院时间较短（P<0.001），且更早接受PCI治疗（P<0.001）。多因素Logistic回归分析显示，AMI发作后的入院时间（比值比：1.032，95%置信区间：1.013-1.052，P=0.001）以及AMI发作至PCI的时间（比值比：1.449，95%置信区间：1.163-1.804，P=0.001）是AVB早期恢复的独立因素。
对于症状出现较晚且合并高度AVB的下壁AMI患者，AVB恢复的中位时间为5天。AMI发作后较短的入院时间和更早的PCI治疗与AVB的早期恢复独立相关。
