INCIDENCE AND PROGNOSTIC-SIGNIFICANCE OF COMPLETE HEART-BLOCK COMPLICATING ANTERIOR WALL ACUTE MYOCARDIAL-INFARCTION

The incidence of complete heart block (CHB) among 2,560 consecutive patients with acute anterior wall myocardial infarction (MI) was 4% (n = 102). These patients were older, had previous infarction and angina more often, and exhibited a higher rate of in-hospital complications than counterparts without CHB. In-hospital as well as 1- and 10-year post-discharge mortality was significantly higher among patients with CHB (75, 31 and 81%) in comparison to counterparts without block (19, 11 and 48%, respectively; p = 0.001 for each). After adjustment for multiple variables, CHB emerged as an independent predictor of in-hospital death (relative odds 5.7, 95% confidence interval: 3.1-10.4) but not for subsequent mortality. In view of the very high mortality among patients with anterior acute MI exhibiting CHB, high priority should be given to extensive monitoring and aggressive treatment of these patients.