RT Journal Article
SR Electronic
T1 High-degree atrioventricular block complicating ST segment elevation myocardial infarction in the contemporary era
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 40
OP 49
DO 10.1136/heartjnl-2015-308260
VO 102
IS 1
A1 Vincent Auffret
A1 Aurélie Loirat
A1 Guillaume Leurent
A1 Raphael P Martins
A1 Emmanuelle Filippi
A1 Isabelle Coudert
A1 Jean Philippe Hacot
A1 Martine Gilard
A1 Philippe Castellant
A1 Antoine Rialan
A1 Régis Delaunay
A1 Gilles Rouault
A1 Philippe Druelles
A1 Bertrand Boulanger
A1 Josiane Treuil
A1 Bertrand Avez
A1 Marc Bedossa
A1 Dominique Boulmier
A1 Marielle Le Guellec
A1 Jean-Claude Daubert
A1 Hervé Le Breton
YR 2016
UL http://heart.bmj.com/content/102/1/40.abstract
AB Background High-degree atrioventricular block (HAVB) is a common complication of ST segment elevation myocardial infarction (STEMI). HAVB in STEMI is historically considered as a marker of worse outcome but overall data about HAVB in the contemporary era of mechanical reperfusion and potent antiplatelet therapies are scarce.Aim Analysing incidence, clinical correlates and impact on inhospital outcomes of HAVB in a large prospective registry (Observatoire Régional Breton sur l'Infarctus, ORBI) of modern management of STEMI with a special focus on potential differences between patients with HAVB on admission and those who developed HAVB during hospitalisation.Methods All patients enrolled in ORBI between June 2006 and December 2013 were included in the present analysis and were divided into 3 groups: patients without HAVB at any time, patients with HAVB on admission and those who developed HAVB during hospitalisation.Results A total of 6662 patients (age: 62.0 (52.0–74.0) years; male: 76.3%) were included in the present analysis. HAVB was documented in 3.5% of patients, present on admission in 63.7% of patients and occurring during hospitalisation in 36.3%. Patients with HAVB on admission or occurring during the first 24 h of hospitalisation had higher inhospital mortality rates (18.1% and 28.6%, respectively) than patients without (4.5%) or with HAVB occurring beyond the first 24 h of hospitalisation (8.0%). However by multivariable analysis, HAVB was not independently associated with inhospital mortality contrarily to age, presentation as cardiac arrest, anterior STEMI location, reperfusion therapy, cardiogenic shock, mechanical ventilation and occurrence of sustained ventricular tachyarrhythmias or mechanical complication.Conclusions Patients with HAVB had a higher mortality rate than patients without. However HAVB is not an independent predictor of inhospital mortality.