A clinical study of arrhythmias associated with acute myocardial infarction and thrombolysis

Abstract

Background: Arrhythmias are a common occurrence in ACS. This study was undertaken to analyze the incidence, frequency and type of arrhythmias in relation to the site of infarction to aid in timely intervention to modify the outcome in MI and to study the significance of Reperfusion arrhythmias.Methods: 100 patients were evaluated. ECG and cardiac enzymes were studied. Arrhythmias complicating AMI in terms of their incidence, timing, severity, type, relation, reperfusion and results were studied.Results: Of the 100 cases, 74% were males and 26% females of which incidence being common between 4th to 7th decades of life. AMI was common in patients with Diabetes and Hypertension (23% each). Incidence of AWMI (58%) is higher than IWMI (40%). Out of all arrhythmias, Ventricular Tachycardia was seen in 24% cases with 50% mortality and preponderance to Antero Lateral Myocardial Infarction. Sinus Tachycardia was seen in 23% of cases with preponderance to Antero Lateral Myocardial Infarction and persistence of Sinus Tachycardia was a prognostic sign, mortality being 22%. Complete Heart Block and Sinus Bradycardia were seen with IWMI, incidence being 53.8% and 100% respectively. Bundle Branch Block was common in AWMI (31%) than IWMI (10%). Among 64 thrombo-lysed cases, 21 had Reperfusion Arrhythmias without any mortality, whereas remaining 43 without Reperfusion Arrhythmias had mortality of 18.6%.Conclusions: According to the study, Tachy-arrhythmias are common with Anterior Wall Myocardial Infarction and Brady-arrhythmias in Inferior Wall Myocardial Infarction. Reperfusion Arrhythmias are a benign phenomenon and good indicator of successful reperfusion.

A clinical study of hemodynamically significant arrhythmias and QTc interval associated with thrombolysed and non thrombolysed acute myocardial infarction patients

“…Overall the number of male cases is highly significant (74%) as compared to females (26%). 6 Similar observations were made by Martin TC et al, MI incidence recorded as 85% between 35 and 75 years of age, recorded prevalence of AMI was 72% in males and 28% in females which is similar to ours where AMI was 63.3% in male subjects and 33.7% in female subjects.…”

“…In current study diabetes is recorded for 23.1% subjects as risk factor of AMI which is almost similar to Mhatre MA et al which also recorded diabetes in 23% cases. 6 Similarly diabetes was found in 19% by Svensson AM et al, study. 8 Current study found AWMI (30.7%) followed by IWMI (25.1%) were the most common affected location in MI patients.…”

“…23% had hypertension recorded higher prevalence of AMI. 6 Similarly Kokobo Y et al, recorded the frequency of high-normal blood pressure as 12.2% and hypertension as 35.3% in CVD patients. 6 In current study 34.2% subjects were smokers and experienced the AMI, this is similar to the findings of Teo KK e al, in their study they found that smoking was associated with a greater risk of non-fatal AMI (odds ratio [OR] 2.95, 95% CI 2.77-3.14, p<0.0001) compared with non-smoking; risk increased by 5.6% for every additional cigarette smoked.…”

“…6 Similarly Kokobo Y et al, recorded the frequency of high-normal blood pressure as 12.2% and hypertension as 35.3% in CVD patients. 6 In current study 34.2% subjects were smokers and experienced the AMI, this is similar to the findings of Teo KK e al, in their study they found that smoking was associated with a greater risk of non-fatal AMI (odds ratio [OR] 2.95, 95% CI 2.77-3.14, p<0.0001) compared with non-smoking; risk increased by 5.6% for every additional cigarette smoked. 7 Current study records alcohol as risk factor in 30.7% subjects, which is substantiated by the result Sonia SA et al study which recorded 11.2% vs. 29.1% male patients of AMI were alcoholic.…”

The Pattern of Cardiac Arrhythmias in Acute ST Elevated Myocardial Infarction and their in-hospital Outcome

“…In this study, majority of the patients had anterior wall ( anterior, antero-septal& extensive anterior) myocardial infarction (54%).This is comparable with the study of Rajhans et al, 7 where overall incidence of anterior wall was higher (56%) than inferior wall which was 44%. Similarly according to Mhatre et al 8 incidence of anterior wall myocardial infarction (58%).…”