Abstract
Objective: To determine the frequency of conduction abnormalities and in hospital mortality in patients with acute anterior wall myocardial infarction (MI).
Methodology: This study was conducted from 1 January to 30 June 2011 in the Cardiology Department of Lady Reading Hospital, Peshawar. Patients who presented with acute anterior wall MI were included. Those patients who were having renal failure, Hypo or Hyperkalemia, history of valve replacement, coronary artery bypass graft and those who were using Beta blocker, Lanoxin and Calcium channel blocker (Verapamil, Diltiazem) were excluded. Patients were followed daily for development of AV blocks until discharged or died. Data was analyzed using statistical package for social sciences (SPSS) version 15.
Results: A total of 309 patients were included, out of which 228 (73.8 %) were males and 81 (26.2 %) were females, having mean age of 58.88 years. Conduction abnormalities developed in 33(10.67%) patients during hospital stay. Among these, A-V blocks were present in 3.5% and Intraventricular blocks in 7.11% patients. During hospital stay, 56 (18.1%) patients died. LBBB developed in 6 patients in which, 3(50%) patients died whereas, RBBB developed in10 patients in which 6(60%) patients died, Bifascicular block developed in 6 patients in which 3 died and complete heart block (CHB) developed in 9 patients with 77.7% mortality.
Conclusion: CHB in anterior wall MI is an uncommon finding in this thrombolytic era but associated with high incidence of in-hospital death even if these patients are timely thrombolysed and paced.