Work

Temporal trends of atrioventricular block in acute coronary syndrome patients from the ACSIS registry

Year: 2025

Type: article

Abstract: Background High-degree atrioventricular block (HDAVB) is a life-threatening complication among acute coronary syndrome (ACS). Objective Our aim was to investigate temporal trends of the last two decades in incidence and prognosis of patients with HDAVB among patients who present with ACS. Methods We evaluated 18,717 ACS patients from the multicenter ACSIS (Acute Coronary Syndrome Israeli Survey) registry. Temporal trends were examined in early (2000–2010) and late (2013–2021) periods. Results Overall, HDAVB was diagnosed in 657 (3.5%) patients: 489 (4.25%) patients in the early period vs 168 (2.33%) in the late period ( P < .001). Temporary pacemakers were implanted more frequently in the early vs the late period (59.4% vs 47%, P = .007), though implantation rate of permanent pacemakers was similar in both periods (11.3% vs 16.7%, P = .095). Patients with HDAVB from the late period experienced lower major adverse cardiovascular events (30.3% vs 43.8%, P = .003), 30-day mortality (18.9% vs 29.2%, P = .013) and 1-year mortality (26.1% vs 36.5%, P = .022). In multivariable analysis, admission Killip class >II (hazard ratio [HR] 2.85, P < .001), diabetes mellitus (HR 1.46, P = .01), and late period (vs early period, HR 1.44, P = .05) were independent predictors for 1-year mortality Conclusion ACS patients with HDAVB experience elevated short- and long-term mortality rates overall. However, there is improvement in outcomes for this population throughout the years.

Source: Heart Rhythm O2

DOI: 10.1016/j.hroo.2025.03.001