INCIDENCE OF AV BLOCK IN INFERIOR STEMI

Abstract

Background: Atrioventricular (AV) block is an AV conduction disorder that can manifest in various settings, with varying symptomaticity and severity. Complications of acute ST-elevation myocardial infarction (STEMI) as AV blocks are often observed.

Methodology: All newly diagnosed inferior wall MI patients were included to conducted in French Medical Institute for children and mother (FMIC) from 1^st January 2023 to December 2023. Prior ethical clearance from the Institutional Ethics Committee was taken. Written informed consent was taken from the study participants. Detailed history, physical examination, and necessary investigations were done in all patients. Electrocardiographic (ECG) were recorded on admission and everyday thereafter till hospital discharge. AV block was evaluated. All this information was recorded on Performa for analysis.

Results: Overall there were 40 registered patients of Inferior wall STEMI cases, of which 32 (80%) were men and 8 (20%) women. Sex ratio was 4 (male to female) based on the revealed ratio of Inferior wall ST elevation Myocardial infarction are more common in males than females. The age of patients varied between 39 to 85 years. We revealed that the mean and median ages of patients diagnosed with inferior wall ST elevation Myocardial infarction were 58.1 and 59.0 years respectively. Most of cases were seen at 60 years. When the age range based on gender was analyzed, it turned out that the age range for males varied between 39-85 with mean age of 58.13 years, whereas in female the age varied between 48-85 years with a mean range 59 years. We analyzed the Presentation of patient in emergency department 30 patients (75%) came in acute stage and 10 patients (25%) came in late stage. Regarding to involvement the coronary arteries, RCA (Right coronary artery) is more effected 27 patients (67.5%), LCX (left circumflex artery) 7 patient (17.5%) and 4 patients (10%) by LAD (left anterior ascending artery). For 2 patients (5%) angiography was not done due to financial problem. The most common involved coronary is RCA. This involvement shows by angiography. Patients presented in emergency department for treatment, 30 patients (75%) in acute stage and 10 (25%) present in late stage. In acute presentation for 19 patients (47.5%) primary PCI done, for 5 patients (12.5%) thrombolysis and PCI done, for 2 pats (5%) give atropine-apply TPM and Primary PCI done, 1 patient (2.5%) advised CABG,1 patient (2.5%) just response with atropine,1 patient (2.5%) just thrombolysis and 1 patient (2.5%) give atropine and urgent PCI done. In late presentation for 9 patients (22.5%) PCI done and 1 patient (2.5%) thrombolysis and PCI done. In total 40 patients in both presentation (acute and late) for 19 patients (47.5%) PPCI done, PCI for 9 patients (22.5%), 6 patients (15%) thrombolysis done than PCI, for 2 pats (5%) give atropine-apply TPM and Primary PCI done, 1 patient (2.5%) advised CABG,1 patient (2.5%) just response with atropine,1 patient (2.5%) just thrombolysis and 1 patient (2.5%) give atropine and urgent PCI done.

Conclusion: Findings of our study were similar to data presented in other parts of the world, with some significant differences that could be explained to be related to the local factors.