High-grade atrioventricular block in patients with acute myocardial infarction. Insights from a contemporary multi-center survey

Hilmi Alnsasra, Binyamin Ben-Avraham, Shmuel Gottlieb, Merav Ben-avraham, Ran Kronowski, Zaza Iakobishvili, Ilan Goldenberg, Boris Strasberg, Moti Haim

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


High-grade atrioventricular block (HAVB) is a frequent complication of acute myocardial infarction (AMI) and is associated with increased morbidity and mortality. We aimed to evaluate the incidence, predictors, and prognostic significance of HAVB in a contemporary cohort of patients with AMI, in the recent era of early reperfusion. Patients with acute coronary syndromes (n = 11,487) during the years 2000–2010 were included. Patients were divided into two groups: with HAVB (n = 308, 2.7%) and without HAVB (n = 11,179, 97.3%). The incidence of HAVB decreased from 4.2% in 2000 to 2.1% in 2010 (p for trend < 0.01). Patients with HAVB were more likely to develop in-hospital complications. Independent predictors of developing HAVB were older age, ST-elevation myocardial infarction (STEMI), smoking and Killip class ≥ 2 on admission. 30-day and 1-year mortality rates were significantly higher in the HAVB as compared to the non-HAVB group (24% vs. 4.9%, p < 0.01, 33.5% vs. 10%, p < 0.01, respectively). Multivariable logistic regression analysis revealed that, HAVB was associated with increased 30-day (OR - 3.97; 95% CI - 1.96–8.04) and 1-year mortality risk (HR - 2.02; 95% CI - 1.3–3.1). Similar estimates were obtained for STEMI and non-STEMI (NSTEMI). In conclusion, although the incidence of HAVB decreased over the last decade, the associated morbidity and mortality are still high in these patients despite early reperfusion therapy.

Original languageEnglish
Pages (from-to)386-391
Number of pages6
JournalJournal of Electrocardiology
Issue number3
StatePublished - 1 May 2018
Externally publishedYes


  • Atrioventricular block
  • Non-ST elevation myocardial infarction
  • Prognosis
  • ST-elevation myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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