Association Between Intraventricular Conduction Disorders and Intrahospital Prognosis in Patients with Acute Coronary Syndrome

Mehdi Latif, Mohammad Salehi, Nazanin Janfada, Leila Foroutan, MohammadMoein Ashrafi


Background and Objectives: Acute coronary syndrome (ACS) is one of the most common heart diseases. Interventricular conduction disorders are complications of acute myocardial infarctions and have different types, such as left and right bundle branch blocks and left anterior and posterior hemiblocks. The prognosis of this disease can affect therapeutic methods, duration of hospitalization, and timely intervention decisions. Therefore, in this study, we evaluated the relationship between interventricular conduction disorders and the prognosis of patients with ACS.

Materials and Methods: Using the convenience sampling method, this analytical case-control study was conducted on 140 patients with ACS (61 patients in the case group and 79 patients in the control group) who were treated from March to August 2013. The underlying variables of the risk factors for ACS were evaluated, along with prognostic evaluation factors, in two groups: a case group (patients with interventricular conduction disorders) and a control group (patients without interventricular conduction disorders). Data were analyzed with SPSS v. 17 software using the chi-squared test, the analysis of variance test, Student’s t-test, and Fisher's exact test.

Results: The mean age of patients was 64.1 ± 5.8 years in the case group and 62.9 ± 8.8 years in the control group. No significant relationship was observed between ACS risk factors, such as hyperlipidemia, diabetes, hypertension, previous myocardial infarction, and smoking, and the prognosis of patients with ACS. The mean ejection fraction was 39.7 in the case group and 45.1 in the control group, so a significant relationship existed between the two groups (P<0.05). In addition, systolic heart failure was more common in the case group than in the control group. 

Conclusion: We found that the presence of auscultation (rales sound) and shortness of breath on the first day of hospital admission in the case group were significantly different from the control group (P<0.05). Furthermore, the ejection fraction in the case group was lower than in the control group, and the frequency of mitral regurgitation in the case group was higher than in the control group. These factors can effectively predict the prognosis of patients with ACS. Finally, we found that interventricular conduction disorders weakened the prognosis of patients with ACS.



interventricular conduction disorder, acute coronary syndrome, prognosis

Full Text:



Goldman L, Schafer AI. Goldman's Cecil medicine, expert consult premium edition -enhanced online features and print, single volume, 24: Goldman's Cecil Medicine. London, UK: Elsevier Health Sciences; 2012.

Longo D, Fauci A, Kasper D, Hauser S, Jameson J, Loscalzo J. Harrison's principles of internal medicine. 18th ed. New York, NY: McGraw Hill Professional; 2011.

Khodadadi A, Sayadi A, Smaeli H. Evolution of Knowledge of the principles of self care in acute coronary syndrome patients admitted to Aliebn Abitaleb Rafsanjan university hospital during 2009. Journal of Rafsanjan Faculty of Nursing and Midwifery and Paramedical. 2010;5:8-16.

Bucholz EM, Butala NM, Rathore SS, Dreyer RP, Lansky AJ, Krumholz HM. Sex differences in long-term mortality after myocardial infarction: a systematic review. Circulation. 2014 Jul 22:CIRCULATIONAHA-114. PMID:25052403

Cortigiani L, Bigi R, Gigli G, Coletta C, Mariotti E, Dodi C, et al. Prognostic implications of intraventricular conduction defects in patients undergoing stress echocardiography for suspected coronary artery disease. Am J Med 2003; 115(1): 12-8. PMID:12867229

Otterstad JE, Gundersen S, Anderssen N. Left anterior hemiblock in acute myocardial infarction. Incidence and clinical significance in relation to the presence of bundle branch block and to the absence of intraventricular conduction defects. Acta Med Scand 1978; 203(6): 529-34. PMID:665320

Melgarejo-Moreno A, Galcerá-Tomás J, Consuegra-Sánchez L, Alonso-Fernández N, Díaz-Pastor Á, Escudero-García G, Jaulent-Huertas L, Vicente-Gilabert M, Galcerá-Jornet E, Padilla-Serrano A, de Gea-García J. Relation of new permanent right or left bundle branch block on short-and long-term mortality in acute myocardial infarction bundle branch block and myocardial infarction. The American journal of cardiology. 2015 Oct 1;116(7):1003-9. DOI:10.1016/j.amjcard.2015.07.019

Iwasaki J, Kono K, Katayama Y, Takahashi N, Takeuchi K, Tanakaya M, Osawa K, Shiraki T, Saito D. Prognostic significance of right bundle branch block in patients with acute inferior myocardial infarction. Acta medica Okayama. 2009;63(1):25-33. DOI:10.18926/AMO/31857

Wong CK, Gao W, Stewart RA, van PN, French JK, Aylward PE, et al. Risk stratification of patients with acute anterior myocardial infarction and right bundle-branch block: importance of QRS duration and early ST-segment resolution after fibrinolytic therapy. Circulation 2006; 114(8): 783-9. DOI:10.1161/CIRCULATIONAHA.106.639039

Kurisu S, Inoue I, Kawagoe T, Ishihara M, Shimatani Y, Hata T, et al. Right bundle-branch block in anterior acute myocardial infarction in the coronary intervention era: acute angiographic findings and prognosis. Int J Cardiol 2007; 116(1): 57-61. DOI:10.1016/j.ijcard.2006.02.010

Lisowska A, Tycinska A, Knapp M, Lisowski P, Musial WJ. The incidence and prognostic significance of cardiac arrhythmias and conduction abnormalities in patients with acute coronary syndromes and renal dysfunction. Kardiol Pol 2011; 69(12): 1242-7. PMID:22219098

Sanaani A, Yandrapalli S, Jolly G, Paudel R, Cooper HA, Aronow WS. Correlation between electrocardiographic changes and coronary findings in patients with acute myocardial infarction and single-vessel disease. Annals of translational medicine. 2017 Sep;5(17). PMID:28936441

Fazzini PF, Marchi F, Pucci P. Prognostic value of intraventricular conduction blocks in acute myocardial infarction. Acta Cardiol 1976; 31(6): 455-65. PMID:1088051

Moloudi A, Sabzi F, Hajimoradi B. Prevalence of left bundle branch block & congestive heart failure. Journal of Kermanshah University of Medical Sciences (J Kermanshah Univ Med Sci). 2010 Apr 3;14(1).


  • There are currently no refbacks.