Effective delayed percutaneous coronary intervention for advanced atrial ventricular block in patients with recent myocardial infarction
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- 作者：Tomonori Itoh ; Toshihide Mifune ; Kentaro Komuro ; Tetsuya Fusazaki ; Hiroshi Endoh ; Motoyuki Nakamura
- 关键词：Advanced atrio-ventricular block ; Recent myocardial infarction ; Percutaneous coronary intervention ; Late reperfusion
- 刊名：Journal of Cardiology Cases
- 出版年：2012
- 出版时间：September, 2012
- 年：2012
- 卷：6
- 期：3
- 页码：e84-e87
- 全文大小：980 K
文摘
We present a case of effective late reperfusion for atrio-ventricular conduction recovery in a patient with recent myocardial infarction complicated by advanced atrio-ventricular block (AVB). A 50-year-old Japanese man was transferred to our hospital with a recent diagnosis of myocardial infarction 44 h after onset. We performed emergent coronary angiography on Day 5 because he developed bradycardia with two to one advanced AVB resistant to atropine without chest pain or ST-T changes. Coronary angiography showed the right coronary artery (RCA) with total proximal occlusion. Emergent percutaneous coronary intervention (PCI) was performed to the RCA. Just after PCI, the PR interval was shortened to 0.25 s. Moreover, the PR interval was shortened to 0.18 s at Day 16. This report shows the new finding that delayed PCI may be effective in patients with recent myocardial infarction complicated by new AVB outside of the usual therapeutic window of 12 h.