Factors associated with late onset of advanced atrioventricular block in acute Q wave inferior infarction

Abstract

To elucidate the clinical characteristics associated with advanced atrioventricular (AV) block that appears relatively late (more than 24 hours) after the onset of myocardial infarction (MI), 101 patients with acute Q wave inferior MI were studied. Fourteen patients had late-onset advanced AV block, and 87 patients were free of AV block. The hospital mortality rate was 11%. Multivariate analysis was performed to determine the important variables associated with the occurrence of late advanced AV block and hospital mortality rates based on 12 clinical variables. Colloid osmotic pressure, right atrial pressure, serum potassium level, and number of segments with advanced asynergy were the significant factors associated with the occurrence of late advanced AV block, whereas advanced asynergic segments and alveolar arterial oxygen difference were important in the consideration of hospital mortality rates. Therefore not only the extent of myocardial ischemia but also the increases in the extracellular potassium level and interstitial fluid are some of the factors that are associated with the occurrence of late advanced AV block in acute inferior MI. Late advanced AV block, in itself, has no significant influence on hospital mortality rates.