Why the study?
Ventricular arrhythmias remain a serious complication of AMI often causing hemodynamic instability and sudden cardiac death, prompting evaluation of their incidence, risk factors, and in-hospital outcomes.
Ventricular arrhythmias complicate nearly one-third of AMI presentations, predominantly within the first 48 hours, and are associated with significantly worse in-hospital outcomes, reinforcing the need for continuous early ECG monitoring.
Findings on VA incidence and risks in AMI may aid ED stratification; leaves open prospective validation before guiding practice.
BACKGROUND: Ventricular arrhythmias remain one of the most serious complications of acute myocardial infarction (AMI), often leading to hemodynamic instability and sudden cardiac death. OBJECTIVES: The study aimed to determine the incidence of ventricular arrhythmias in AMI patients presenting to the emergency department, identify associated risk factors, and assess their impact on in-hospital outcomes. METHODOLOGY: This cross-sectional analytical study was conducted at Shaikh Zayed Hospital, Lahore, Pakistan, from March 2024 to September 2024, and included 196 patients diagnosed with AMI. Clinical, demographic, laboratory, and echocardiographic data were recorded. Patients were continuously monitored using ECG during their stay in the emergency department and subsequently throughout hospitalization for up to eight days to detect ventricular arrhythmias, defined as ventricular tachycardia or ventricular fibrillation. RESULTS: Ventricular arrhythmias were observed in 58 patients (29.6%), including ventricular tachycardia in 19.9% and ventricular fibrillation in 9.7%. Most events (70.7%) occurred within the first 48 hours. Significant predictors included age > 60 years (adjusted odds ratio (AOR) = 1.9), hypertension (AOR = 2.0), diabetes mellitus (AOR = 2.1), anterior wall infarction (AOR = 2.3), Killip class ≥ II (AOR = 2.8), and delayed hospital arrival > 6 hours (AOR = 2.5). Patients with arrhythmias had longer hospital stays (6.2 ± 2.1 vs. 4.8 ± 1.7 days, p = 0.001) and higher in-hospital mortality (20.7% vs. 5.8%, p = 0.001). CONCLUSIONS: Ventricular arrhythmias occurred in nearly one-third of AMI patients, predominantly within the first 48 hours, and were associated with significantly worse in-hospital outcomes. Continuous ECG monitoring during the emergency phase and throughout hospitalization is essential for early detection. The risk factors for ventricular arrhythmias included hypertension, diabetes mellitus, age above 60 years, delayed hospital arrival beyond six hours, low serum potassium, low serum magnesium, and anterior wall infarction.
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Mazhar et al. (2025) studied this question.
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