Does the incidence and timing of arrhythmias differ among patients with intermediate coronary syndrome, small AMI, and frank AMI?
Patients with intermediate coronary syndrome or small AMI have a low risk of serious arrhythmias after 48 hours, suggesting prolonged ECG monitoring may not be necessary for these groups compared to those with frank AMI.
Abstract The incidence of arrhythmias has been investigated in 100 patients with intermediate coronary syndrome (ICS), in 42 with small acute myocardial infarction (AMI) and in 147 with frank AMI. A continuous ECG has been monitored from admission until at least 48 hours after the onset of symptoms. Bradyarrhythmias, atrial flutter and fibrillation and short‐lasting ventricular tachycardia were significantly more often seen among patients with small and frank AMI than among patients with ICS. Complete AV block was seen in one patient with small AMI, otherwise no patients with small AMI or ICS had AV block, ventricular tachycardia or fibrillation. Serious arrhythmias did not start more than 48 hours after onset of symptoms in patients with small AMI or ICS as opposed to patients with frank AMI. Serious arrhythmias were more often seen in patients with pre‐existing CHD than in patients without. The results suggest that the observation period in monitored beds can be short, and in case of need omitted, without taking any great risks in patients with small AMI and ICS. This is in contrast to patients with frank AMI, who certainly need these beds and often for more than 48 hours.
O Skjaeggestad (Fri,) studied this question.
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