Abstract
Evaluation of Heart Block in Inferior Wall Myocardial Infarction in Context of Intervention: Temporary Pacemaker Implantation versus Conservative Medical Management, a Single Centre Experience from Eastern India
Highlights
BackgroundAcute Inferior Wall Myocardial Infarction (IWMI) constitutes about 40-50% of all Acute Myocardial Infarction (AMI) [1]
The Association of occurrence of Complications following AV Block in Inferior Wall AMI with Diabetes was not significant though a higher occurrence was found among diabetics (Odds ratio=4.000 [0.837-19.102], p(1-tailed Fischer Exact)=0.078 (Table 3d)
On the basis of this retrospective study, we conclude that Diabetes Mellitus is an important risk factor for AV conduction disturbances following Inferior Wall AMI and it is important to keep in mind the increased risk of occurrence of Complications due to Complete Heart Block in diabetics, rather the Blocks may be refractory to Temporary Cardiac Pacing support, forcing us to think of an early decision to implant a Permanent Pacemaker which could prevent Temporary Pacemaker Implantation (TPI) associated complications like Lead Displacement related complications, Pericardial Tamponade, Infective Endocarditis, Pneumonitis, Basal Atelectasis, Decubitus Ulcers etc
Summary
BackgroundAcute Inferior Wall Myocardial Infarction (IWMI) constitutes about 40-50% of all Acute Myocardial Infarction (AMI) [1]. The Inferior Wall of the Heart is supplied by branches from the Right Coronary Artery (RCA) and the Circumflex branch of Left Coronary Artery. Acute Inferior Wall Myocardial Infarction (IWMI) mostly occurs due to obstruction of the blood supply in the Right Coronary Artery. Arrhythmias that occurs early in the course of IWMI is usually due to Vagal over-activity and is usually transient [4] Those Bradyarrhythmias that occur late (i.e. after 6 hours of IWMI) are usually resistant to pharmacologic treatment and often require temporary pacing to improve prognosis (mostly in cases of Complete Heart Blocks) [5]. Association between Inferior wall Myocardial infarction (IWMI) and various degree of heart block is well known Objective of this study was to re-evaluate the need of temporary pacemaker and their effectiveness versus conservative management in those patients
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