Inflammation begets isolated atrioventricular conduction disturbances in young an observation from indian registry data

Abstract

Abstract Background High grade AV block is less commonly encountered in patients <60 years. The aetiological role of inflammatory conditions is not well studied in this group of patients. Purpose To determine the prevalence of myocardial inflammation in young patients presenting with High grade AV block and assess its response to immunosuppression. Methodology This is a prospective, registry based, observational study conducted at two centers from Jan 2020 to Dec 2021. Myocardial inflammation was detected using Cardiac PET, and/or histopathological examination. Those with evidence of inflammation were started on graded immunosuppression. Results 318 patients were enrolled. Mean EF was 55.2±7.0%. Cardiac PET was performed in 87/318 (27.3%). Myocardial inflammation was seen in 57/87 (65%). LV basal septum was most commonly involved. 44/57 (77%) were started on immunosuppressive therapy after excluding indolent tuberculosis.8 patients died during follow-up with all deaths being sudden in nature. 5/44 (11.3%) had reversal of CHB with resolution of cPET findings. Conclusion Significant proportion of young patients with High grade AV block have segmental myocardial inflammation. Immunosuppression helps restore AV conduction in some of these patients. Long-term studies are required to assess adverse impact of inflammation on cardiac contractile function. Funding Acknowledgement Type of funding sources: None.