BACKGROUND Acute myocardial infarction (AMI) which is associated with complications like arrhythmias and ischemia is one of the lead causes of mortality all over the world. Holter monitoring has successfully been employed to continuously monitor patients with AMI. The present study was aimed at investigating the importance of 24-hour Holter monitoring in acute ST-elevation myocardial infarction in the early post-infarction period. METHODS A total of 56 patients with acute ST-elevation myocardial infarction in Baghdad Teaching Hospital were monitored via 24-hour Holter monitoring and echocardiography as soon as they were released from coronary care unit and admitted to the medical wards. Data on age, sex, risk factors for ischemic heart disease, site of infarction, and reception of thrombolytic therapy were collected from all of the patients. The collected data was analysed using SPSS version 10. RESULTS Of the 56 patients with AMI, 9 were reported with significant arrhythmias, 20 with non-significant arrhythmias, and 27 without any arrhythmias. Seven patients (12.5%) were found to have ST-depression MI for at least 1 minute during 24-hour Holter monitoring, and 5 of them (62%) had an uneventful hospital course. The results also showed that 27 patients (48%) had left ventricular dysfunction, and 23 of them had abnormal Holter findings (arrhythmias and/or ST depression). Moreover, 11 of the 13 patients with LV dysfunction had cardiac events. CONCLUSIONS Ventricular arrhythmia and LV dysfunction were found to be indicators of cardiac events in patients with AMI, which can be monitored through 24-hour Holter monitoring. Therefore, utilisation of this monitoring technique is recommended for all patients with AMI once they are admitted in medical wards.

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