Key result
Following acute myocardial infarction, ventricular premature beats were the most common arrhythmia (23%), while atrial fibrillation and ventricular tachycardia were significantly associated with left ventricular dysfunction (p=0.018).
Observational (n=100)
No
p-value: p=0.018
In the first week following acute myocardial infarction, ventricular premature beats are the most common arrhythmia, and both ventricular tachycardia and atrial fibrillation are significantly associated with left ventricular dysfunction.
May inform early post-MI arrhythmia surveillance; hypothesis-generating for AF/VT links to LV dysfunction, needing prospective confirmation.
OBJECTIVES: Acute myocardial infarction continues to be a major health problem.50% of deaths with acute myocardial infarction is said to occur within first 24 hours after myocardial infarction and is attributed to arrhythmias.Arrhythmic deaths remain the major cause of death with reduced left ventricular ejection fraction or frequent ventricular premature beats.The objective of this study is to assess various arrhythmias following myocardial infarction within one week and to study the association of these arrhythmias with left ventricular dysfunction.METHODS: Minimum of 100 cases diagnosed as acute myocardial infarction (European/ ACC Guidelines 2000) with arrhythmias collected by simple random sampling.Data was collected in a pre-tested proforma by meeting objectives of the study, detailed history, physical examination, ECG changes from day 1 to day 7 and whenever necessary, echocardiography to assess ejection fraction, and serum enzyme levels.RESULTS: Male to female ratio with 4:1, mortality was more in the group with risk factors of hypertension, smoking and diabetes.Commonest arrhythmias noticed in this study were VPBs -23%, ST-22%, BBB -20%, SB-19%, VT -6%, and AF-4%.In 17 out of 69 patients, thrombolysis therapy developed reperfusion arrhythmias of which VPBs being commonest.In addition to commonest arrhythmias there was a significant association between VT, AF and LV dysfunction.CONCLUSION: The commonest arrhythmias encountered were ventricular premature beats followed by sinus tachycardia, sinus bradycardia, bundle branch block and ventricular tachycardia.SB & BBB were more common in IWMI where as ST, VPBs, AF and flutter were more common with AWMI.In addition to arrhythmias, LV dysfunction added to the mortality.
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Tippannavar et al. (2012) conducted an observational in Acute myocardial infarction (n=100). Observation of arrhythmias was evaluated on Prevalence of arrhythmias and association with left ventricular dysfunction (p=0.018). Following acute myocardial infarction, ventricular premature beats were the most common arrhythmia (23%), while atrial fibrillation and ventricular tachycardia were significantly associated with left ventricular dysfunction (p=0.018).
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