Prevalence, Temporal Evolution, and Impact on Survival of Ventricular Conduction Blocks in Patients With Acute Coronary Syndrome and Cardiogenic Shock

The American Journal of Cardiology
Heli TolppanenCardShock study investigators and for the GREAT Network

Abstract

Changes in QRS duration and pattern are regarded to reflect severe ischemia in acute coronary syndromes (ACS), and ventricular conduction blocks (VCBs) are recognized high-risk markers in both ACS and acute heart failure. Our aim was to evaluate the prevalence, temporal evolution, association with clinical and angiographic parameters, and impact on mortality of VCBs in ACS-related cardiogenic shock (CS). Data of 199 patients with ACS-related CS from a prospective multinational cohort were evaluated with electrocardiogram data from baseline and day 3. VCBs including left or right bundle branch block, right bundle branch block and hemiblock, isolated hemiblocks, and unspecified intraventricular conduction delay were assessed. Fifty percent of patients had a VCB at baseline; these patients were older, had poorer left ventricular function and had more often left main disease compared with those without VCB. One-year mortality was over 2-fold in patients with VCB compared with those without VCB (68% vs 32%, p<0.001). All types of VCBs at baseline were associated with increased mortality, and the predictive value of a VCB was independent of baseline variables and coronary angiography findings. Interestingly, 37% of the VCBs were tran...Continue Reading

References

Feb 1, 2003·European Heart Journal·Frans Van de WerfUNKNOWN Task Force on the Management of Acute Myocardial Infarction of the European Society of Cardiology
Aug 16, 2011·Circulation. Arrhythmia and Electrophysiology·Aapo L AroHeikki V Huikuri
Nov 16, 2013·Scandinavian Cardiovascular Journal : SCJ·Martin JaklPetr Widimsky
Mar 31, 2015·European Journal of Heart Failure·Veli-Pekka HarjolaUNKNOWN GREAT network
Sep 16, 2015·Intensive Care Medicine·A MebazaaJ Januzzi

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