Frequency of Third-Degree Atrioventricular Block in Inferior Wall Myocardial Infarction with Right Ventricular Infarction

Authors

  • Masroor Hussain Shah Department of Cardiology, Ayub Teaching Hospital, Abbottabad, KP, Pakistan.
  • Matiullah Khan Department of Cardiology, Ayub Teaching Hospital, Abbottabad, KP, Pakistan.
  • Ayesha Bibi Department of Cardiology, Ayub Teaching Hospital, Abbottabad, KP, Pakistan.
  • Sardar Adnan Saif Department of Cardiology, Ayub Teaching Hospital, Abbottabad, KP, Pakistan.
  • Mariam Ejaz Department of Cardiology, Ayub Teaching Hospital, Abbottabad, KP, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i4.862

Keywords:

Complete Atrioventricular Block, Inferior Wall Myocardial Infarction, Right Ventricular Infarction

Abstract

Background: Complete atrioventricular block is a significant complication in inferior wall myocardial infarction and right ventricular infarction patients. Understanding its prevalence and demographic determinants are essential in order to optimize the clinical management and the evaluation of prognosis, most significantly in low-resource health systems. Objective: To determine the frequency of third-degree atrioventricular block with right ventricular infarction in a patient with acute inferior wall myocardial infarction.
Study Design: Cross-sectional study. Duration and Place of Study: The study was conducted from September 2024 to February 2025 at the Cardiology Unit and Emergency Department of Ayub Teaching Hospital, Abbottabad. Methodology: A total of 110 patients aged 35–85 years, diagnosed with IWMI and RVI, were included. Diagnosis was based on clinical symptoms, electrocardiographic findings, and cardiac biomarkers. Third-degree AV block was identified through conventional 12-lead ECG, and right ventricular infarction was confirmed using right-sided precordial leads. Results: The mean age of patients was 63.29 ± 8.96 years, with a predominance of male patients (76.4%). Third-degree AV block occurred in 20.9% of patients, with a significant gender difference (73.1% of females vs. 4.8% of males, p<0.001). Rural residents had a higher incidence (39%) of AV block compared to urban residents (0%, p<0.001). Conclusion: The study confirms a significant frequency of third-degree AV block in patients with IWMI and RVI, with a marked predisposition in females, rural residents, and individuals from low socioeconomic backgrounds.

Downloads

Download data is not yet available.

References

Levis, J. (2011). ECG Diagnosis: Complete Heart Block. The Permanente Journal, 15(2). https://doi.org/10.7812/tpp/11-053

Bhasin, D., Kumar, R., Agarwal, T., Gupta, A., & Bansal, S. (2022). A case with inferior wall myocardial infarction and conduction abnormalities: Addressing the diagnostic challenges. Cureus, 14(3). https://doi.org/10.7759/cureus.23614

Ahmed, I. A., Khalid, N. H., Abd-Elmagid, A. E., Abdullah, M. A., Musa, A. M., & AL-Qarni, N. O. (2022). Common coronary artery occlusions in patients with myocardial infarction. Pan African Medical Journal, 42. https://doi.org/10.11604/pamj.2022.42.254.34762

Bouhaddoune, Y., Bouchlarhem, A., Bazid, Z., Ismaili, N., & El Ouafi, N. (2023). Right ventricular infarction: Epidemiological, clinical, and angiographic characteristics and the outcomes through the experience of a moroccan cardiology department. Annals of Medicine & Surgery, 86(2), 660-665. https://doi.org/10.1097/ms9.0000000000001528

Nägele, M. P., & Flammer, A. J. (2022). Heart failure after right ventricular myocardial infarction. Current Heart Failure Reports, 19(6), 375-385. https://doi.org/10.1007/s11897-022-00577-8

Siopi, S., Antonitsis, P., Karapanagiotidis, G. T., Tagarakis, G., Voucharas, C., & Anastasiadis, K. (2024). Cardiac failure and Cardiogenic shock: Insights into pathophysiology, classification, and hemodynamic assessment. Cureus. https://doi.org/10.7759/cureus.72106

Balta, A., Ceasovschih, A., Șorodoc, V., Dimitriadis, K., Güzel, S., Lionte, C., Stătescu, C., Sascău, R., Mantzouranis, E., Sakalidis, A., Vlachakis, P., Tsioufis, P., Kordalis, A., Tsiamis, E., Tsioufis, K., & Șorodoc, L. (2022). Broad electrocardiogram syndromes spectrum: From common emergencies to particular electrical heart disorders. Journal of Personalized Medicine, 12(11), 1754. https://doi.org/10.3390/jpm12111754

Silvetti, E., Lanza, O., Romeo, F., Martino, A., Fedele, E., Lanzillo, C., Crescenzi, C., Fanisio, F., & Calò, L. (2023). The pivotal role of ECG in cardiomyopathies. Frontiers in Cardiovascular Medicine, 10. https://doi.org/10.3389/fcvm.2023.1178163

Zhang, C.-D., Sun, L.-J., Chen, B.-X., Han, J.-L., Chen, S.-M., Wang, X.-Y., Fan, Y.-Y., Li, D., & Xu, X.-Y. (2022). Extracorporeal membrane oxygenation successfully treated massive right ventricular myocardial infaction with aneurysm. PubMed, 19(8), 618–621. https://doi.org/10.11909/j.issn.1671-5411.2022.08.009

Iwanaga, J., Manoharan, S., Cardona, J. J., Anadkat, S., Saga, T., Loukas, M., & Tubbs, R. S. (2023). Anatomical study of the atrioventricular nodal branch of the heart. Cureus. https://doi.org/10.7759/cureus.35412

Meng, X., Song, M., Zhang, K., Lu, W., Li, Y., Zhang, C., & Zhang, Y. (2024). Congenital heart disease: Types, pathophysiology, diagnosis, and treatment options. MedComm, 5(7). https://doi.org/10.1002/mco2.631

Sapna, F., Raveena, F., Chandio, M., Bai, K., Sayyar, M., Varrassi, G., Khatri, M., Kumar, S., & Mohamad, T. (2023). Advancements in heart failure management: A comprehensive narrative review of emerging therapies. Cureus. https://doi.org/10.7759/cureus.46486

Clemmensen, P., Bates, E. R., Califf, R. M., Hlatky, M. A., Aronson, L., George, B. S., Lee, K. L., Kereiakes, D. J., Gacioch, G., Berrios, E., & Topol, E. J. (1991). Complete atrioventricular block complicating inferior wall acute myocardial infarction treated with reperfusion therapy. The American Journal of Cardiology, 67(4), 225-230. https://doi.org/10.1016/0002-9149(91)90550-5

Ullah, R., Ali, J., Bilal, A., Jan, D. A., Rahim, A., & Sajjad, W. (2023). Frequency of right ventricular infarction in patients with acute inferior wall myocardial infarction presenting at a tertiary care hospital, Peshawar. Pakistan Heart Journal, 56(2), 163-166. https://doi.org/10.47144/phj.v56i2.2372

Ramzan, M., Zab, J., Javed, M. K., & Ali, F. (2018). Acute inferior wall myocardial infarction. The Professional Medical Journal, 25(02), 287-291. https://doi.org/10.29309/tpmj/2018.25.02.458

Mehreen, S., Ahmed, A., & Tahir, M. (2016). Frequency of high degree AV blocks in acute inferior myocardial infarction and their impact on clinical outcomes. Pakistan Armed Forces Medical Journal, (2), 281.

Siddique, M., Hussain, S., & Ahmed, S. (2016). FREQUENCY AND OUTCOME OF RIGHT VENTRICULAR INFARCT: PATIENTS WITH INFERIOR WALL MYOCARDIAL INFARCTION DURING HOSPITAL STAY. The Professional Medical Journal, 23(10), 1288-1292.

Pirzada, A. M., Zaman, K. S., Mahmood, K., Sagheer, T., Mahar, S. A., & Jafri, M. H. (2009). High degree Atrioventricular block in patients with acute inferior Myocardial Infarction with and without Right Ventricular involvement. J Coll Physicians Surg Pak, 19(5), 269-74.

Ullah, Z., Khan, I., Khan, W., & Khan, M. A. (2022). Frequency of complete heart block in patients with acute inferior wall myocardial infarction. Pakistan Journal of Medical and Health Sciences, 16(5), 89-90. https://doi.org/10.53350/pjmhs2216589

Khan, I. S., Malik, M. N., & Afzal, M. (2013). The effect of right ventricular infarction on clinical outcome of inferior wall myocardial infarction. Ann Pak Inst Med Sci, 9(2), 91-4. https://apims.net/apims_old/Volumes/Vol9-2/The%20effect%20of%20right%20ventricular%20infarction%20on%20clinical%20outcome%20of%20inferior%20wall%20Myocardial%20Infarction.pdf

Downloads

Published

2025-04-20

How to Cite

Frequency of Third-Degree Atrioventricular Block in Inferior Wall Myocardial Infarction with Right Ventricular Infarction. (2025). Indus Journal of Bioscience Research, 3(4), 329-334. https://doi.org/10.70749/ijbr.v3i4.862