TY - JOUR
T1 - Risk markers of late high-degree atrioventricular block in patients with left ventricular dysfunction after an acute myocardial infarction: a CARISMA substudy
AU - Gang, Uffe Jakob Ortved
AU - Jøns, Christian
AU - Jørgensen, Rikke Mørch
AU - Abildstrøm, Steen Zabell
AU - Messier, Marc D.
AU - Haarbo, Jens
AU - Huikuri, Heikki V.
AU - Thomsen, Poul Erik Bloch
AU - AUTHOR GROUP
AU - Raatikainen, M. J. P.
AU - Hartikainen, J.
AU - Virtanen, V.
AU - Boland, J.
AU - Anttonen, O.
AU - Hoest, N.
AU - Boersma, L. V. A.
AU - Platou, E. S.
AU - Becker, D.
AU - Schrijver, G.
AU - Robbe, H.
AU - Mahaux, V.
AU - Christiansen, L. K.
AU - Huikuri, P.
AU - Karjalainen, P.
PY - 2011
Y1 - 2011
N2 - Aims High-degree atrioventricular block (HAVB) after acute myocardial infarction (AMI) is associated with increased risk of mortality. Risk markers and predictors of HAVB occurring after AMI are largely unknown. The aim of this study was to assess the predictive value of risk markers derived from a series of non-invasive and invasive tests for the development of HAVB documented by an implantable loop recorder (ILR) in late convalescent phases of an AMI. Methods and results The study included 292 patients with AMI and subsequent left ventricular dysfunction without prior HAVB or implanted pacemaker. An ILR was implanted for continuous arrhythmia surveillance. Risk stratification testing was performed at inclusion and 6 weeks after AMI. The tests included echocardiography, electrocardiogram (ECG), 24 h Holter monitoring, and an invasive electrophysiological study. High-degree atrioventricular block was documented in 28 (10%) patients during a median follow-up of 2.0 (0.4-2.0) years. Heart rate variability (HRV) measures and non-sustained ventricular tachycardia occurring at the week 6 Holter monitoring were highly predictive of HAVB. Power law slope <-1.5 ms(2)/Hz was the most powerful HRV parameter (HR = 6.02 [2.08-17.41], P <0.001). Conclusion Late HAVB development in post-AMI patients with left ventricular dysfunction can be predicted by risk stratification tests. Measures of HRV reflecting autonomic dysfunction revealed the highest predictive capabilities
AB - Aims High-degree atrioventricular block (HAVB) after acute myocardial infarction (AMI) is associated with increased risk of mortality. Risk markers and predictors of HAVB occurring after AMI are largely unknown. The aim of this study was to assess the predictive value of risk markers derived from a series of non-invasive and invasive tests for the development of HAVB documented by an implantable loop recorder (ILR) in late convalescent phases of an AMI. Methods and results The study included 292 patients with AMI and subsequent left ventricular dysfunction without prior HAVB or implanted pacemaker. An ILR was implanted for continuous arrhythmia surveillance. Risk stratification testing was performed at inclusion and 6 weeks after AMI. The tests included echocardiography, electrocardiogram (ECG), 24 h Holter monitoring, and an invasive electrophysiological study. High-degree atrioventricular block was documented in 28 (10%) patients during a median follow-up of 2.0 (0.4-2.0) years. Heart rate variability (HRV) measures and non-sustained ventricular tachycardia occurring at the week 6 Holter monitoring were highly predictive of HAVB. Power law slope <-1.5 ms(2)/Hz was the most powerful HRV parameter (HR = 6.02 [2.08-17.41], P <0.001). Conclusion Late HAVB development in post-AMI patients with left ventricular dysfunction can be predicted by risk stratification tests. Measures of HRV reflecting autonomic dysfunction revealed the highest predictive capabilities
U2 - https://doi.org/10.1093/europace/eur165
DO - https://doi.org/10.1093/europace/eur165
M3 - Article
C2 - 21665919
SN - 1099-5129
VL - 13
SP - 1471
EP - 1477
JO - Europace : European pacing, arrhythmias, and cardiac electrophysiology
JF - Europace : European pacing, arrhythmias, and cardiac electrophysiology
IS - 10
ER -