Abstract P195: Acute Hemodynamic Effects of Accelerated Idioventricular Rhythm in Primary Percutaneous Coronary Intervention
Background The hemodynamic effects of Accelerated idioventricular rhythm (AIVR) in primary Percutaneous Coronary Intervention (PCI) are poorly described. Therefore the purpose of this study was to systematically assess the direct hemodynamic effects of AIVR as well as the influence of infarct related artery location.
Methods In this prospective cohort study, 52 consecutive patients with AIVR following reperfusion in primary PCI were analysed. Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and heart rate were determined during periods of AIVR and sinus rhythm. Rate Pressure Product (RPP) was defined as SBP multiplied by heart rate. We grouped patients according to infarct related artery location, i.e. right coronary artery and left anterior descending coronary artery.
Results AIVR, compared to sinus rhythm, resulted in a significant reduction of SBP, DBP and RPP irrespective of infarct related artery location (see table⇓). There were no differences in hemodynamic effects between proximal or distal occlusions of right coronary artery or left coronary artery.
Conclusion The occurrence of AIVR following reperfusion is associated with a significant decline in both systolic and diastolic blood pressure. This hemodynamic effect was independent of the infarct related artery and/or location of the occlusion. This finding underscores the clinical relevance of AV-sequential conductance and/or atrial contraction to maintain systemic blood pressure in the setting of mechanical reperfusion of an acute myocardial infarction.