CAUSES, CLINICAL CHARACTERISTICS AND HOSPITAL OUTCOMES OF PATIENTS WITH HIGH DEGREE AV BLOCKS

Abstract

ABSTRACT Objective: To evaluate the causes, symptoms, clinical course and outcome of patients admitted to Cardiology department with high degree AV blocks Methodology: All patients admitted to Cardiology unit with high degree AV blocks st st from 1 January 2012 to 31 May 2012 were included in the study. Baseline clinical characteristics, causes, signs and symptoms, management strategies and outcomes were recorded on a pre-designed Performa. Statistical analysis was done using SPSS version 19. Results: A total of 127 patients were included in the study. Males were 55(43.3%) and 72(56.7%) were females mean age was 65 ±13.73 years and mean heart rate at presentation was 36±4.32 were (95(74.81%) patients having aged more than 50 years). Total 83(65.35%) were hypertensive and 55(43.30%) were diabetics. The causes found were coronary artery disease in 43(33.9%), beta blockers in 32(25.19%), rate limiting calcium channel blockers in 8(6.9%), digoxin in 3(2.3%), Hyperkalemia (K+>5.5 mq/l) in 11 (8.66%), deranged urea (>50 mg/dl) in 45(35.43%), Increased creatinine in 26(20.46%) patients. While no cause was found in 69(54.33%) patients. The symptoms including dizziness/vertigo found in 102 (80.31%), Presyncopae in 95(74.80%), syncope in 64(50.39%), fits in 5(3.93%) and dyspnea in 45(35.43%). Among them 22 (17.32%) patients responded to Atropine. were 105(82.68%) patients required TPM (Temporary Pacemaker). Of these 105 patients, 43 patients required permanent pacemaker (PPM). patients died were 4(3.1%) Conclusion: Most patients were aged more than 50 years, The common causes of block were ischemic and degenerative heart diseases. Presenting symptoms were vertigo, dizziness, presyncope, syncopal attacks and dyspnea. A quarter of patients responded to atropine, of remaining half required permanent pacemaker.