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RMJ. 2007; 32(2): 135-138

Arrhythmia and Conduction Disorders in Acute Inferior Myocardial Infarction with Right Ventricular Involvement.

Jahanbakhsh Samadikhah, Serred Hadi Hakim, Azin Alizadeh Asl, Rasoul Azarfarin, Simin Ghaffari, Ahmadali Khalili.

Objectives: To assess the prognostic impact of Right Ventricular (RV) myocardial involvement in
patients with inferior MI.
Methods: One hundred seventy patients who were admitted to cardiac care unit of Madani Heart
Hospital, Tabriz, Iran with the diagnosis of inferior MI with (group1) or without (group 2)
simultaneous involvement of RV were studied from 2005 to 2006. Patients presenting within 12
hours of symptom onset were eligible for inclusion. Those with simultaneous Anterior wall MI,
patients undergoing primary percutaneous transluminal coronary angioplasty and those with renal
impairment (creatinine >2 mg/dl) were excluded.
Results: Eighty eight percent of the patients with RVMI and 75% with isolated inferior MI had
some type of arrhythmia. AV block occurred in 42% of the infarctions with RV involvement and
only in 29% of the control group. Intra ventricular conduction disturbance (IVCD) also were more
frequent in RVMI (29.4% VS 13.1%, p=0.021), especially the RBBB (20% VS 7.4%, P=0.003).
Ventricular fibrillation (VF) was observed in 5.2% and 1.2% and ventricular tachycardia in 26%
and 12.2% respectively. In 27% of patients with RVMI it was necessary to implant a pacemaker as
compared to 10% in control group. Mortality was higher in the patients with inferior infarction
extended to the RV (15.3% vs 3.5%., P= 0.0001). There was not a meaningful difference in
incidence of LBBB between group 1 and 2 (3.1% vs 2.9% P=0.9).
Conclusion: Patients with inferior MI who also have RV myocardial involvement are at increased
risk of death and arrhythmias.(Rawal Med J 2007;32:135-138).

Key words: Right ventricle, myocardial infarction, arrythmias,

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