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(Circulation. 1973;47:257.)
© 1973 American Heart Association, Inc.

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Significance of High Degree Atrioventricular Block in Acute Posterior Myocardial Infarction

The Importance of Clinical Setting and Mechanism of Block

MICHAEL ROTMAN M.D.¹; GALEN S. WAGNER M.D.¹; ROBERT A. WAUGH M.D.¹

¹ From the Division of Cardiology of the Department of Medicine, Duke University Medical Center, Durham, North Carolina.

This report evaluates the morbidity and mortality, during hospitalization and follow-up, of a subgroup of patients with posterior or diaphragmatic myocardial infarction (PDMI) who developed high degree A-V block via a type I mechanism and in the absence of power failure (pulmonary edema or cardiogenic shock). This subgroup was not at any higher risk of hospital morbidity, hospital mortality, or 1-year mortality than three other groups: (a) patients with PDMI but neither high degree A-V block nor initial power failure; (b) patients with other infarct sites who developed high degree A-V block in the absence of power failure; and (c) patients with other infarct sites but neither high degree A-V block nor initial power failure. The significance of subgrouping patients with high degree A-V block by the quantity of clinical heart failure is exemplified by a review of the literature and the present study.

Key Words: Power failure • Type I second-degree A-V block • Third-degree A-V block

Submitted on August 15, 1972
Accepted on October 5, 1972