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      Early Development of High-Degree Atrioventricular Block in Inferior Acute Myocardial Infarction Is Predicted by a J-Point/R-Wave Ratio above 0.5 on Admission


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          This study assessed the ability of simple clinical and electrocardiographic (ECG) variables routinely obtained on admission to identify patients with inferior myocardial infarction who are at high risk of developing high-degree atrioventricular (AV) block within the first 24 h of hospitalization in 205 patients. The admission ECGs were classified into two patterns based on the J-point to R-wave amplitude ratio: pattern 1: those with J-point/R-wave ratio <0.5; pattern 2: patients with J-point/R-wave ratio ≥0.5 in ≥2 inferior leads (II, III and aVF). High-degree AV block was found in 10.2% of the patients (21 of 205 patients; 5 and 16% of the patients with initial patterns 1 and 2, respectively, p = 0.014). Multivariate logistic regression analysis revealed that the only variables independently associated with high-degree AV block were the initial ECG pattern 2 versus 1 (odds ratio, OR, 4.47, 95% confidence interval, CI, 1.18–16.9; p = 0.0276), age (OR 1.06, 95% CI 1.01–1.12; p = 0.0254); Killip class >1 (OR 2.33, CI 0.83–6.54; p = 0.1065) and thrombolytic therapy (OR 0.32, 95% CI 0.11–0.93; p = 0.037).

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          Author and article information

          S. Karger AG
          March 1999
          22 March 1999
          : 90
          : 4
          : 274-279
          Department of Cardiology and Epidemiology Unit, Rabin Medical Center, Petah Tiqva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
          6858 Cardiology 1998;90:274–279
          © 1998 S. Karger AG, Basel

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          Page count
          Figures: 1, Tables: 3, References: 38, Pages: 6
          Coronary Care

          General medicine,Neurology,Cardiovascular Medicine,Internal medicine,Nephrology
          Acute myocardial infarction,Atrioventricular block,Prognosis,Electrocardiogram,Prediction


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