Clinical Characteristics and Prognostic Analysis of Acute Inferior Myocardial Infarction Complicated by Severe Atrioventricular Block

WU Jie; YAN Zhu

doi:10.13919/j.issn.2095-6274.ZHJY202505053

Abstract：Objective To analyze the clinical characteristics and prognostic factors of patients with acute inferior myocardial infarction complicated by severe atrioventricular block(AVB).Methods A retrospective study was conducted on 150 patients with acute inferior myocardial infarction admitted to the Fifth People's Hos-pital of Huaian from May 2022 to May 2024.According to whether the patients had severe AVB,they were divided into the severe AVB group(35 patients)and the non-severe AVB group(115 patients).The clinical baseline data,coronary angiography and percutaneous coronary intervention(PCI)parameters,prognostic indicators,and compli-cations were compared between the two groups.Results There were no significant differences between the two groups in terms of age,gender,the proportion of patients with hypertension,hyperlipidemia,diabetes,smoking his-tory,drinking history,number of affected coronary vessels,success rate of PCI vessel opening,average number of stents implanted per case,and in-hospital mortality(P＞0.05).However,the distribution of infarct-related arteries showed significant differences between the groups,with the severe AVB group having a significantly higher pro-portion of right coronary artery involvement compared to the non-severe AVB group(P＜0.05).The recovery time for atrioventricular conduction in the severe AVB group was significantly longer than that in the non-se-vere AVB group(P＜0.001).The in-hospital mortality rates between the two groups were not significantly different(P＞0.05),but the mortality rate during follow-up was significantly higher in the severe AVB group(22.86％vs.8.70％,OR=3.12,95％CI:1.12-8.67,P＜0.05).Regarding heart function recovery,the severe AVB group had a predominance of NYHA class Ⅱ-Ⅲ(71.43％),while the non-severe AVB group was mainly classified as NYHA class Ⅰ-Ⅱ(77.40％),with a significant difference between the groups(P＜0.05,Cliff's delta=0.28).In terms of com-plications,the incidence of right ventricular myocardial infarction(40.00％vs.20.00％),heart failure(48.57％vs.24.35％),and hypotensive shock(22.22％vs.12.17％)was significantly higher in the severe AVB group compared to the non-severe AVB group(P＜0.05),but the incidence of malignant arrhythmias showed no statistical difference(17.78％vs.13.91％,P＞0.05).Conclusion Patients with acute inferior myocardial infarction complicated by AVB predominantly exhibit right coronary artery involvement.Moreover,the one-year mortality rate,as well as the incidence of right ventricular myocardial infarction,heart failure,and hypotensive shock,is significantly increased.These findings suggest that patients of this type require enhanced prognostic monitoring and comprehensive man-agement of complications.