A Comprehensive study on Conduction Block in Acute Stemi in Thanjavur Medical College

Abstract

BACKGROUND: Acute myocardial infarction is a grave clinical condition that remains the leading cause of mortality worldwide. World wide around 3 million people suffer from STEMI and another 4 million people develops NSTEMI. Conduction blocks are commonly seen in patients associated with myocardial infarctions. Several studies have shown data that AV and infranodal blocks are present approximately 12 to 25% in acute MI. But this largely varies with studies. Several studies have pointed out that the AV blocks complicating STEMI are associated with increased morbidity and mortality. The prognosis of the patient may vary depending upon the type of AV block and timely intervention as well. OBJECTIVES: To study the prevalence of conduction block in acute STEMI in Thanjavur Medical College and the association with various modifiable and non modifiable risk factors and also the prognosis of the patients. METHODS: The study was conducted as a cross sectional observational study in Thanjavur Medical College from the period of JANUARY 2021 to JANUARY 2022. A total of 100 cases who presented as acute STEMI in Thanjavur Medical College were studies and the prevalence of various heart blocks developed in them where studied and their associations were various risk factors and outcomes were assessed. All the cases were assessed for demographic and clinical presentation b the principal investigator using a pre structured proforma. Patients were followed along the course of treatment ; serial ECG monitoring was done. patient was followed with ECHO and assessed until the patient is discharged or has been expired. Patients were subjected to following investigations to identify the comorbidities : CBC, RBS, RFT, LIPD PROFILE. The data were entered in MS office excel SPFTWARE and analysed using SPSS version 2.0 RESULTS: In our study 100 subjects were taken into consideration and Commonest age group who developed acute STEMI were within the age group of 45 to 60 years males. Incidence of conduction block in our study was 28 %. In literature the conduction blocks in STEMI varies from 12% to 25% depending on various studies. Also the mortality of study subjects was 16% in the study. Age, gender, and comorbidities have no association with conduction block or prognosis of patients. In our study AWMI have the highest incidence being 64% followed by IWMI which is 17%. In our study the most common conduction block was infranodal blocks, of which RBBB more than LBBBB (7%). Conduction blocks and alcoholism has statistically significant association with prognosis of the patient so are the Ejection fraction and killip class at presentation. CONCLUSION: The incidence of heart block in the study was 28% There is significant association between alcoholism and conduction block. RBBB and LBBB are the most common conduction blocks seen. Bundle branch blocks are more seen with AWMI and AV nodal blocks are common with inferior wall MI. There is significant association with mortality of the patient as well as the duration of stay of discharged patients with conduction blocks. There is also association between conduction block and Killip class at the time presentation and reduced Ejection fraction in ECH