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BackgroundCardiac arrhythmias and conduction abnormalities complicating acute myocardial infarction (AMI) have been associated with adverse prognosis in numerous reports. Small studies have frequently associated different arrhythmias with various distributions of myocardial infarctions. We analyzed a nationally representative hospital discharge database to evaluate the relationship between the location of AMI and the associated arrhythmias and conduction abnormalities and their impact on in‐hospital mortality.MethodsWe searched the National Hospital Discharge Survey database for patients with a diagnosis of AMI and collected data on the associated arrhythmias and conduction abnormalities. In‐hospital death was used as end point for analysis.ResultsA total of 21,807 patients, representing 2,632,217 hospital discharges in the United States, with a primary diagnosis of AMI from 1996 to 2003 were included in this analysis. Patients with inferior or posterior AMI were more likely to develop complete heart block compared to those with anterior or lateral AMI (3.7% vs 1.0%, hazard ratio [HR] = 3.9, p ≤ 0.001), but less likely to die prior to hospital discharge (7.7% vs 11.3%, HR = 0.65, p ≤ 0.001).ConclusionsPatients with an inferior or posterior AMI are more likely to develop conduction system abnormalities when compared to patients with an anterior or lateral AMI. On the other hand, anterior or lateral MI is a significant predictor of in‐hospital death. Copyright © 2009 Wiley Periodicals, Inc.

SummaryBackground: There is a paucity of reports evaluating the perioperative risk of noncardiac surgery in patients with hypertrophic cardiomyopathy (HCM).Hypothesis: The study was undertaken to evaluate the incidence of acute myocardial infarction (MI) and all-cause inhospital mortality following noncardiac surgery in patients with HCM.Methods: We searched the National Hospital Discharge Survey database for patients with a diagnosis of HCM who had undergone noncardiac surgery. Cases were matched by age, gender, and year of surgery. Death or acute MI were used as endpoints for analysis.Results: From 1996 to 2002, 227 patients with HCM were matched with 554 controls (representing national estimates of 25,874 HCM and 50,326 controls patients). Patients with HCM were more likely than controls to have a history of atrial fibrillation (22.7 vs. 10.6%, p < 0.001) and of congestive heart failure (CHF) (24.2 vs. 14.1%, p < 0.001). The in-hospital incidence of death or MI was higher in patients with HCM than in controls (6.7 vs. 2.5%, p < 0.001 for death and 2.2 vs. 0.3%, p < 0.001 for MI). After correcting for age, gender, race, presence of hypertension, diabetes mellitus, history of coronary artery-disease, history of CHF, atrial fibrillation, and ventricular arrhythmias in a multivariate binary logistic regression model, the presence of HCM increased the odds of death by 61% (odds ratio [OR] = 1.61, 95% confidence interval

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Despite having an ICD, HD patients have approximately a three-fold increase in total mortality and may therefore not extract the same survival benefits from the ICD as their non-HD counterparts. If duplicated in larger randomized trials, these results may demonstrate the futility of implanting defibrillators in HD patients.