Clinical and electrocardiographic features of complete heart block after blunt cardiac injury: A systematic review of the literature
| Autor: | Pierpaolo Lupo, Sara Foresti, Guido De Ambroggi, Hussam Ali, Francesco Furlanello, Angelica Fundaliotis, Lorenzo Semprini, Gianluca Epicoco, Riccardo Cappato |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Fatal outcome Cardiac troponin Heart block 030204 cardiovascular system & hematology Pacemaker implantation Electrocardiography 03 medical and health sciences 0302 clinical medicine Blunt Heart Conduction System Physiology (medical) Internal medicine Commotio cordis medicine Humans 030212 general & internal medicine Atrioventricular Block business.industry medicine.disease Myocardial Contusions Av conduction Cardiology Permanent pacemaker Cardiology and Cardiovascular Medicine business |
| Zdroj: | Heart Rhythm. 14:1561-1569 |
| ISSN: | 1547-5271 |
| Popis: | The underlying mechanisms and temporal course of complete heart block (CHB) after blunt cardiac injuries (BCIs) are poorly understood, and a systematic analysis of available data is lacking. In this systematic review, PubMed was searched for publications of reported cases of CHB-BCI analyzing clinical findings, electrocardiographic features, temporal course, and outcomes. Case reports on CHB-BCI were available for 50 patients, mainly secondary to traffic or sport accidents. A fatal outcome occurred in 10 of 50 (20%) of patients, while a structural damage of the atrioventricular (AV) conductive system was evident in 4 of 8 (50%) of necropsy studies. Clinical manifestation of CHB-BCI occurred within 72 hours of injury in 38 of 47 (∼80%) of patients, and 1:1 AV conduction was restored within 7–10 days in about half of early survivors. Permanent pacemaker implantation was indicated in 22 of 42 (∼50%) of early survivors because of recurrent or permanent CHB. Cardiac troponins, when analyzed, were elevated in 12 of 13 (∼90%) of patients, and electrocardiographic features of aberrancy were present in 29 of 40 (>70%) of patients. In conclusion, CHB secondary to BCI is associated with 20% mortality mainly occurring in the early posttraumatic period and most of the deaths are due to or triggered by this malignant arrhythmia. Recurrent or permanent CHB requiring pacemaker implantation occurs in ∼50% of survivors. A structural damage of the AV conductive system can be found in 50% of necropsy studies. |
| Databáze: | OpenAIRE |
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