THE STUDY OF CONDUCTION BLOCKS IN ACUTE MYOCARDIAL INFARCTION PATIENTS ADMITTED IN TERTIARY CARE HOSPITAL IN CENTRAL INDIA: A PROSPECTIVE OBSERVATIONAL STUDY

Background: Acute Myocardial infarction (AMI) is one of the most fatal diseases of human community. Various types of conduction blocks (CB) develop following an AMI. Hence the present study was undertaken to study the various types of conduction blocks in acute ST elevation myocardial infarction (STEMI) patients admitted in Tertiary care hospital in central India. Method: A total 140 patients of age ≥18 years with symptoms and signs suggestive of AMI having ECG changes consistent with STEMI and rise in cardiac markers presenting with conduction disturbances were included in the study. Results: Among the 140 patients, 62.2% survived, 37.8% were non-survivors.Highest incidence of conduction blocks (28.57%) and maximum non-survivors (22.64%) were in age group of 51-60 years. Most common risk factor among non survivors was HTN+Dyslipidemia 70%, followed by HTN+ DM+ Dyslipidemia (69.23%). Among 22 non-survivors in AWMI, maximum non-survivors seen in killips class 2. In IWMI out of 17 non-survivors, 10(53.8 %) seen in killips class 1. In ALWMI 3 (75%) non-survivors seen in killips class 1. In ASWMI maximum non-survivors 4(66.7%) seen in killips class 3. In IRPWMI non survivors seen in class 2,3,4 (33.33% each). In patients with QRBBB maximum non-survivors seen in killips class 2. Maximum non-survivors seen in killips class1 seen the in patients with CHB. Multivariate analysis of variables showed that patients having CHB, first degree AV block, QRBBB and patients with killips class4 have significant independent prediction for in hospital non-survivors. Highest Non-survivors in QRBBB (41.51%) and in AWMI (52.83%). Conclusion:The conduction blocks are associated with higher in-hospital mortality rate and are important predictors of poor outcome in patients with AMI (STEMI).