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- Title
Long-Term Prognostic Significance and Electrophysiological Evolution of Intraventricular Conduction Disturbances Complicating Acute Myocardiai Infarction.
- Authors
Pagnoni, Franco; Finzi, Andrea; Valentini, Romano; Ambrosini, Francesco; Lotto, Antonio
- Abstract
Fifty-nine patients with post-infarctional, isolated intraventricular conduction disturbances (IVCD) who survived the acute stage of myocardial infarction were followed up after hospital discharge/or a mean period of 11.4 ± 4.8 months. Fourteen patients (24%] had HV interval prolongation (>55 ms) during AMI (group A), and 45 patients had normal HV intervals (76%. group B). His bundle recordings were repeated during follow-up in 48 survivors after a mean period of 7.2 ±0.7 months. Infranodal conduction delay in (he acute stage of infarction was correlated with a higher incidence of heart failure during AMI (78% of patients in group A vs 22% in group B, p < 0.001), and with higher rate of cardiac mortality during follow-up (50% in group A vs 13% in group B. p < 0.01). Survivors of group A showed a higher functional NVHA class, a higher incidence of CHF, and a higher prevalence of complex ventricular arrhythmias at Holter monitoring. No statistically significant difference in late sudden death was evident between the two groups of patients, and the global incidence of late AV block was 2%. At repeat His bundle recording no significant change (>5 ms) in HV interval could he demonstrated in comparison to the acute phase recording, neither in patients with prolonged nor in patients with normal HV time. We conclude (hat HV prolongation in patients with isolated, post-infarctional IVCD is correlated with a worse prognosis, both during acute infarction and during the follow-up period, which presumably reflects wider anatomic damage in comparison to patients with normal HV time. The low incidence of late AV block and the electrophysiological demonstration of the stability of infranodal conduction several months after AMI indicate that these patients do not require permanent prophylactic pacing after acute myocardial infarction.
- Subjects
HEART conduction system; MYOCARDIAL infarction complications; PROGNOSIS; ELECTROPHYSIOLOGY; PATIENTS; HIS bundle
- Publication
Pacing & Clinical Electrophysiology, 1986, Vol 9, Issue 1, p91
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/j.1540-8159.1986.tb05364.x