THE PORTRAITS OF PATIENTS WITH MYOCARDIAL INFARCTION COMPLICATED BY CARDIAC CONDUCTION DISORDERS

Objective, to comparatively analyze the clinical and historical data of patients with myocardial infarction (MI) complicated by heart block, in the absence of indications for continuous cardiac pacing and in the presence of indications for pacemaker implantation in the acute and delayed periods after the index event. Subjects and methods. The authors formed a cohort of patients with prior MI (2011-2015) complicated by cardiac conduction disorders. Group 1 included 72 patients in whom a pacemaker (PM) had not been implanted; Groups 2 (n=46) and 3 (n=68) consisted of MI patients who had indications for early and delayed pacemaker implantation, respectively. Results Group 1 showed a preponderance of patients with inferior ST-segment elevation MI (STEMI), second-degree atrioventricular (AV) block, single-vessel coronary artery disease, and successful percutaneous coronary intervention. Group 2 included patients with anterior non-STEMI complicated by Killip class II-IV who had multivessel coronary artery disease, mainly with third-degree AV block. In Group 3, there were equal proportions of STEMI and inferior non-STEMI complicated by second-degree AV block corrected by continuous cardiac pacing at 3.2±1.9 years after an acute coronary event. Conclusion. The found differences in the clinical and historical data of patients with MI complicated by heart block suggest that it is advisable to elaborate an algorithm that determines the management tactics for patients with impaired cardiac conduction in acute MI.