Association of Arrythmias With Acute Myocardial Infarction in the Peri - I Nfarction Period: A Prospective Study

Abstract

BACKGROUND:Arrythmias have been frequently associated with Myocardial Infarction (MI) since long. There are many studies about monitoring or recording of arrythmias in the post MI period ranging from weeks to years. But there is a scarcity of studies in our region (Visakhapatnam) regarding the association of arrythmias with acute myocardial infarction observed within 48 hours of the acute episode. Hence the present study was conducted with an objective of studying the association of arrythmias in the PERI-infarction period. MATERIALS AND METHODS: One hundred consecutive patients were studied who were admitted to the Intensive Cardiac Care Unit (ICCU) after being diagnosed with Acute Myocardial Infarction (AMI). Recruitment lasted for one year. Inclusion criteria: Patients ≥18 years of age admitted to ICCU with AMI with the occurrence of acute episode within 48 hours. Exclusion criteria: Patients <18 years of age, Myocardial infarction >48 hours Patients' ECGs were continuously monitored. Risk factor for heart disease were investigated. RESULTS: Anterior wall MI accounted for a larger group (58%). Overall incidence of ventricular arrythmias was 33%. Sinus arrythmia was predominantly associated with antero-lateral and inferior wall MI. Bundle branch blocks were more accounted for with anterior wall MI. Reperfusion arrythmias were observed in 33 % of subjects. CONCLUSIONS: Acute Myocardial Infarction (AMI) is commonly seen in anterior wall with high incidence of tachyarrythmias and higher mortality whereas inferior wall MI is less common and generally associated with bradyarrythmias and lesser mortality.Sinus bradycardia, if transient, has a protective role in AMI whereas persistent sinus tachycardia is associated with high mortality. Early streptokinase therapy has a favourable impact on mortality in MI and hence should be tried in all the Acute MI patients wh donot have contraindications for streptokinase therapy.