Arrhythmias and Left Ventricular Efficiency Following Infarction and Infarctectomy

The overall mortality of acute myocardial infarction, in most series, is approximated at 30%. In the presence of congestive heart failure and pulmonary edema, the mortality rises to 60%, and the presence of shock to 80% to 100%. In a series of patients with acute myocardial infarction admitted to one hospital, 25% to 50% died secondary to shock, congestive heart failure, myocardial rupture, or arrhythmias. The majority of these patients died within the first 48 to 72 hours following the onset of symptoms. 1 Even with recent improvement in medical management, there has been relatively little change in the mortality rate in this group of patients. Murray, 2 in 1947, first proposed that resection of an acutely infarcted segment of myocardium would improve cardiac function and decrease myocardial irritability. More recently, studies by other workers including Heimbecker et al, 3,4 Glass et al, 5,6 Jude et al, 7 and Crastnopol