Clinical Spectrum and Outcome of Conduction Disturbances in Acute Myocardial Infarction in Thrombolytic Era at a Tertiary Care Centre
Introduction: Significant number of deaths in Acute Myocardial Infarction (AMI) is attributed to conduction disturbances. Aim: To determine the incidence, pattern of conduction disturbances and their clinical outcome in AMI. Materials and Methods: This was a hospital-based study conducted at Sh...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2021-11-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/15668/51328_CE[Ra1]_F_[SH]_GC(AnK)_PF1(AKA_SS)_PFA(AKA_KM)_PN(KM).pdf |
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| author | Ajaz Qadir Aadil Ahmad Mir Abid Rasool Aiman Waseem |
| author_facet | Ajaz Qadir Aadil Ahmad Mir Abid Rasool Aiman Waseem |
| author_sort | Ajaz Qadir |
| collection | DOAJ |
| description | Introduction: Significant number of deaths in Acute Myocardial
Infarction (AMI) is attributed to conduction disturbances.
Aim: To determine the incidence, pattern of conduction
disturbances and their clinical outcome in AMI.
Materials and Methods: This was a hospital-based study
conducted at Sher-E-Kashmir Institute of Medical Sciences
(SKIMS) Jammu and Kashmir, India, a tertiary care hospital from
August 2015 to July 2017, in which a total of 429 patients with
diagnosis of AMI were included. There were 89 (20.7%) patients
with conduction disturbances, and 340 (79.3%) patients without
conduction disturbances. They were examined clinically and
Electrocardiography (ECG) and Echocardiography (Echo)
and many other relevant routine clinical investigations were
done to look for development of conduction disturbances and
other complications of MI. Frequency (n) and percentage (%)
analysis was done on collected data and Fischer's exact test
and Chi-square test was conducted for p-value calculations
and checked for significance.
Results: Out of 429 patients 358 (83.40%) males and 71 (16.60%)
females, mean age 57.6±12.39 years), 219 (51.04%) received
thrombolysis. In those subjects with conduction disturbances,
Atrioventricular (AV) blocks were found in 54 (12.58%) constituting
the maximum subjects, followed by intraventricular blocks in 35
(8.1%). Among AV blocks, complete AV block in 45 (10.48%)
with mostly transient nature and in intraventricular blocks where
Right Bundle Branch Block (RBBB) 17 (3.96%) were the most
common types. Intraventricular blocks were more common in
anterior infarction and AV blocks in inferior infarction (p<0.001).
Age >70 years, diabetes and worse Killip class at presentation
were independent predictors of conduction disturbances.
Temporary pacemaker requirement was more than permanent
pacemaker 24 (26.9%) vs 5 (5.6%). Right coronary artery (RCA)
was dominant artery among AV blocks, which was statistically
significant (p-value 0.003). Mortality was about 12.9% amongst
the subjects of Atrioventricular Node block and 25.7% amongst
those of Intraventricular Blocks while it was 9.41% amongst
the subjects without conduction disturbances (p-value 0.013).
Mean duration of stay in the hospital was 7±2 days.
Conclusion: Conduction blocks were more common in age >70
years, diabetics, in worse Killip class and in inferior infarction.
However, no statistically significant correlation was found
between occurrence of conduction blocks and various risk
factors like hypertension and smoking. |
| first_indexed | 2024-12-19T18:18:06Z |
| format | Article |
| id | doaj.art-d87ad65d00a144b1a386680f715c4933 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-19T18:18:06Z |
| publishDate | 2021-11-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-d87ad65d00a144b1a386680f715c49332022-12-21T20:11:04ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2021-11-011511343810.7860/JCDR/2021/51328.15668Clinical Spectrum and Outcome of Conduction Disturbances in Acute Myocardial Infarction in Thrombolytic Era at a Tertiary Care CentreAjaz Qadir0Aadil Ahmad Mir1Abid Rasool2Aiman Waseem3Senior Resident, Department of Endocrinology, Sher-E-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India Senior Resident, Department of Cardiology, Sher-E-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.Senior Resident, Department of Endocrinology, Sher-E-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, IndiaPostgraduate, Department of Internal Medicine, Hamdard Institute of Medical Sciences and Research, Delhi, India.Introduction: Significant number of deaths in Acute Myocardial Infarction (AMI) is attributed to conduction disturbances. Aim: To determine the incidence, pattern of conduction disturbances and their clinical outcome in AMI. Materials and Methods: This was a hospital-based study conducted at Sher-E-Kashmir Institute of Medical Sciences (SKIMS) Jammu and Kashmir, India, a tertiary care hospital from August 2015 to July 2017, in which a total of 429 patients with diagnosis of AMI were included. There were 89 (20.7%) patients with conduction disturbances, and 340 (79.3%) patients without conduction disturbances. They were examined clinically and Electrocardiography (ECG) and Echocardiography (Echo) and many other relevant routine clinical investigations were done to look for development of conduction disturbances and other complications of MI. Frequency (n) and percentage (%) analysis was done on collected data and Fischer's exact test and Chi-square test was conducted for p-value calculations and checked for significance. Results: Out of 429 patients 358 (83.40%) males and 71 (16.60%) females, mean age 57.6±12.39 years), 219 (51.04%) received thrombolysis. In those subjects with conduction disturbances, Atrioventricular (AV) blocks were found in 54 (12.58%) constituting the maximum subjects, followed by intraventricular blocks in 35 (8.1%). Among AV blocks, complete AV block in 45 (10.48%) with mostly transient nature and in intraventricular blocks where Right Bundle Branch Block (RBBB) 17 (3.96%) were the most common types. Intraventricular blocks were more common in anterior infarction and AV blocks in inferior infarction (p<0.001). Age >70 years, diabetes and worse Killip class at presentation were independent predictors of conduction disturbances. Temporary pacemaker requirement was more than permanent pacemaker 24 (26.9%) vs 5 (5.6%). Right coronary artery (RCA) was dominant artery among AV blocks, which was statistically significant (p-value 0.003). Mortality was about 12.9% amongst the subjects of Atrioventricular Node block and 25.7% amongst those of Intraventricular Blocks while it was 9.41% amongst the subjects without conduction disturbances (p-value 0.013). Mean duration of stay in the hospital was 7±2 days. Conclusion: Conduction blocks were more common in age >70 years, diabetics, in worse Killip class and in inferior infarction. However, no statistically significant correlation was found between occurrence of conduction blocks and various risk factors like hypertension and smoking.https://jcdr.net/articles/PDF/15668/51328_CE[Ra1]_F_[SH]_GC(AnK)_PF1(AKA_SS)_PFA(AKA_KM)_PN(KM).pdfatrioventricular blockselectrical disturbancesheart attackmorbiditymortalitythrombolysis |
| spellingShingle | Ajaz Qadir Aadil Ahmad Mir Abid Rasool Aiman Waseem Clinical Spectrum and Outcome of Conduction Disturbances in Acute Myocardial Infarction in Thrombolytic Era at a Tertiary Care Centre Journal of Clinical and Diagnostic Research atrioventricular blocks electrical disturbances heart attack morbidity mortality thrombolysis |
| title | Clinical Spectrum and Outcome of Conduction Disturbances in Acute Myocardial Infarction in Thrombolytic Era at a Tertiary Care Centre |
| title_full | Clinical Spectrum and Outcome of Conduction Disturbances in Acute Myocardial Infarction in Thrombolytic Era at a Tertiary Care Centre |
| title_fullStr | Clinical Spectrum and Outcome of Conduction Disturbances in Acute Myocardial Infarction in Thrombolytic Era at a Tertiary Care Centre |
| title_full_unstemmed | Clinical Spectrum and Outcome of Conduction Disturbances in Acute Myocardial Infarction in Thrombolytic Era at a Tertiary Care Centre |
| title_short | Clinical Spectrum and Outcome of Conduction Disturbances in Acute Myocardial Infarction in Thrombolytic Era at a Tertiary Care Centre |
| title_sort | clinical spectrum and outcome of conduction disturbances in acute myocardial infarction in thrombolytic era at a tertiary care centre |
| topic | atrioventricular blocks electrical disturbances heart attack morbidity mortality thrombolysis |
| url | https://jcdr.net/articles/PDF/15668/51328_CE[Ra1]_F_[SH]_GC(AnK)_PF1(AKA_SS)_PFA(AKA_KM)_PN(KM).pdf |
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