Study on Site of Acute Myocardial Infarction Associated With Arrhythmias and Outcome
Study on Site of Acute Myocardial Infarction
DOI:
https://doi.org/10.70284/njirm.v5i6.836Keywords:
Arrhythmias, acute myocardial infarction, LVF, outcomeAbstract
Background: Despite considerable progress, Arrhythmias remain a major cause of death in patients with myocardial infarction. Majority of these arrhythmias occurring within the first 24 hours. Few studies have shown that, frequently associated different arrhythmias with various distributions of myocardial infarctions. The aim of the present study is to identify the type of arrhythmias and outcome in patients presenting with acute myocardial infarction. Methods: A total of 100 patients admitted to the ICC unit of Govt. General Hospital, Gulbarga & Basaveshwar Teaching & General Hospital Gulbarga from one year data were taken for present study. The risk factors for cardiac disease were evaluated through history, physical examination and blood investigations. All the patients were monitored for 48-72 hours for arrhythmias. Type and time of onset arrhythmias was also noted. Results: Out of the 100 patients with myocardial infarction studied, 76 patients had arrhythmias. Majority of arrhythmias occurred during less than 12 hours and Sinus tachycardia was the commonest arrhythmia (40%). The overall incidence of mortality was 15%. Majority of mortality occurs with 24 hrs (66.6%). Mortality was more in males (16.25%) than female (10%). Caridogenic shock (40%) and left ventricular failure (33.33%) were the most common cause of death. [Patil M NJIRM 2014; 5(6):88-93]
References
2. Archbold RA, Sayer JW, Ray S, et al. Frequency and prognostic implications of conduction defects in acute myocardial infarction since the introduction of thrombolytic therapy. Eur Heart J. 1998;19(6):893 – 898.
3. Fluck DC, Olsen E, Pentecost BL, et al. Natural history and clinical significance of arrhythmias after acute cardiac infarction. Br Heart J. 1967;29(2):170 – 189.
4. Dubois C, Pierard LA, Smeets JP, et al. Short and long term prognostic: Importance of complete bundle-branch block complicating acute myocardial infarction. Clin Cardiol. 1988; 11(5): 292 – 296.
5. Alpman A, Guldal M, Erol C, et al. The role of arrhythmia and left ventricular dysfunction in patients with acute myocardial infarction and bundle branch block. Jpn Heart J. 1993;34(2):145 – 157.
6. Hindman MC, Wagner GS, JaRo M, et al. The clinical significance of bundle branch block complicating acute myocardial infarction. Circulation. 1978;58(4):689 – 699.
7. Lie KI, Wellens HJ, Schuilenburg RM, Becker AE, Durrer D. Factors influencing prognosis of bundle branch block complicating acute antero-septal infarction. The value of His bundle recordings. Circulation. 1974;50(5):935 – 941.
8. Aufderheide TP. Arrhythmias associated with acute myocardial infarction and
thrombolysis.Emerg Med Clin North Am. 1998 Aug; 16(3): 583-600.
9. Ghuran A V and Camm A J. Ischaemic heart disease presenting as arrhythmias. BMB
2001;59: 193 - 210.
10. Henriques JP, Gheeraert PJ, Ottervanger JP, et al. Ventricular fibrillation in acute
myocardial infarction before and during primary PCI. Int J Cardiol. 2005;105(3):262 – 266.
11. Gomez JF, Zareba W, Moss AJ, McNitt S, Hall WJ. Prognostic value of location and
type of myocardial infarction in the setting of advanced left ventricular dysfunction. Am J Cardiol. 2007; 99(5):642 – 646.
12. Bloor CM, Ehasani A, White FC, Sobel BE: ventricular fibrillation threshold in acute myocardial infarction and its relation to myocardial infarct size. Cardiovasc Res 1975; 9:468.
13. Carmeliet E: Cardiac ionic currents and acute ischemia. From channels to
arrhythmias. Physiol Rev 1999; 79: 927-1017.
14. Ruskin J, McHale PA, Harley A, Greenfield JC, Jr: Pressure-flow studies in main; Effects of atrial systole on left ventricular function. J Clin Invest 1990; 49: 472.
15. Gruppo Italiano per lo Studio della Streptochinasi nell'Infarton Miocardico (GISSI): Effectiveness of intravenous thrombolytic treatment in acute myocardiac infarction. Lancet 1986; 1: 397-40.
16. O'Doheit M, Taylor DI, Quinn E, Vincent R, Chamberlain DA. Five hundred patients with myocardial infarction monitored within one hour of symptoms. Br Med J 1983; 286: 1405-8.
17. Norris RM, Mercer CJ. Significance of idioventricular rhythm in acute myocardial
infarction. Prog Cardiovasc Dis 1974; 16: 455-68.
18. Yee Guan Yap, Trinh Duong, Martin Bland, Marek Malik, Christian Torp- Pederson, Lara Kober et al Temporal trends on the risk of arrhythmic Vs non-arrhythmic deaths in high-risk patients after myocardial infarction: A combined analysis from multicentre trials. European Heart Journal 2005; 26(14): 1385 -139.
19. Ingram et.al. Vomiting as diagnosis in ischemic cardiac pain. BMJ 1980: 281-636.
20. Julian et.al. Disturbance of rate, rhythm and conduction in acute myocardial infarction. AJM 1964: 37-315.
21. Nair M et.al. Conduction disturbance in acute myocardial infarction, incidence and clinical significance. IHJ 1986: 38-335.
22. Nigam et.al. Factors influence early mortality, acute myocardial infarction-A study of 342 patients. 1972.
23. Datey K.K. et al., 100 patients of acute myocardial infarction treated in an intensive coronary care unit. JIMA 1969:52-405.
24. Gupta M.S. et al, Clinical profile of acute myocardial infarction with special reference to risk factors – A 5 year study, JAPI, 1989: 35-55.
25. Scott D. Solomon, Steve Zelenkofske, John JV McMurray, Peter V Finn, Eric Velazquez, George Ertl et al. Sudden death in patients with myocardial infarction and left ventricular dysfunction, heart failure or both. N Eng J Med 2005; 352 (25): 2581 – 2588.
