Study of Arrhythmias in Acute Myocardial Infarction
Keywords:
Acute Myocardial Infarction, Arrhythmias, Sinus tachycardia, Anterior wall MI, Atrioventricular blocks
Abstract
Background: Acute Coronary Syndrome (ACS) represents a Global epidemic. There is not much documented evidence regarding the profile of arrhythmias in the present population of Shimoga. Hence the purpose of this study is to evaluate the incidence and profile of cardiac Arrhythmias in AMI in the first week of hospitalization in a tertiary care hospital in shimoga, karnataka.
Material and Methods: 100 patients of Acute Myocardial Infarction (AMI) admitted to ICCU of Mc Gann Hospital from April 2015 to June 2015 were studied. The first electrocardiogram (ECG) was recorded at the earliest after admission, subsequently at four hourly interval on first day, daily for the duration of stay and as & when needed, cardiac enzymes and 2D echocardiography were done to confirm MI.
Result: The mean age was 52.914 13.19 years with male to female ratio being 2.9:1. Incidence of arrhythmias was 89%, majority (67%) of arrhythmias occurred during first 24 hours. Sinus tachycardia (48%), ventricular premature beats (VPCs) (24%), Sinus bradycardia (22%) and atrial premature complexes (15%) were common arrhythmias encountered in study. Atrioventricular blocks (93.4%) were more common in inferior wall infarctions. Arrhythmias were documented in 90.91% of anterior wall MIs, 83.33% of inferior wall MIs and 100% of combined (anterior and inferior) MIs.
Conclusion: Our observations confirmed the differences in the occurrence of arrhythmias in different setup and locality and need for individualization of management protocol in different setup.
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References
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36. Arun K.N. et al. Retrospective analysis of 500 cases of acute myocardial infarction. J Assoc Physicians India. 1989 Jan;37(1):11. [PubMed]
37. Volpi A. et al. In-hospital prognosis of patients with acute myocardial infarction complicated by primary ventricular fibrillation. N. Engl. J. Med. 1987 July; 317(5): 257-61.
38. Chandrashekhara Rao A.S., S.T. Yavagal and D. Chinnaiah. Conduction disturbances in acute myocardial infarction. Indian Heart J. 1983 Sep-Oct;35(5): 278.
39. Goldberg R.J. et al. Prognosis of acute myocardial infarction complicated by complete heart block (the Worcester Heart Attach Study). Am J. Cardiol. 1992 May; 69(14): 1135-41.
40. Archbold R.A. et al. Frequency and prognostic implication of conduction defects in acute myocardial infarction since the introduction of thrombolytic therapy. Eur Heart J. 1998 Jun;19(6):893-8.
41. Harpaz D. et al. Complete atrioventricular block complicating acute myocardial infarction in the thrombolytic era, SPRINT study group and the Israel Thrombolytic survey group. J. Am. Coll. Cardiol. 1999 November; 34(6): 1721-8.
42. Gupta U.C. and M.L. Kataria. Prognostic significance of arrhythmias after acute myocardial infarction. J Assoc Physicians India. 1992 Dec;40(12):864.
43. Nair M. et al. Conduction disturbance in acute myocardial infarction, incidence and clinical significance. Indian Heart Journal. 1986 Sep-Oct;22 :405-9.
44. Balachandran V. Analysis of intraventricular conduction defects. J Assoc Physicians India. 1998 Jan;46(1) 102.
45. Sgarbossa E.B. et al. Acute myocardial infarction and complete bundle branch block at hospital admission: Clinical characteristics and outcome in the thrombolytic era GUSTO-I Investigations. J. Am. Coll. Cardiol. 1998 January; 31(1): 105-10.
46. Chatterjee S.S. et al. Acute myocardial infarction with conduction disorders. Indian Heart J. 1985 Jul-Aug;37(4):238.
47. Murthy R.S.N. et al. Arrhythmias in acute myocardial infarction, incidence and clinical significance. Indian Heart J. 1984 Sep-Oct;36(5):335.
2. Fabijanic D, Culic V, Bozic I et al. Gender differences in in-hospital mortality and mechanisms of death after the first acute myocardial infarction. Ann Saudi Med. 2006 Nov-Dec; 26(6):455-60.
3. Armstrong William F, and Paul L Mchenry. Ambulatory electrocardiographic monitoring: can we predict sudden death. J Am Coll Cardiol.1985 June; 5(6s1): 13B-6B.
4. Tunstall-Pedoe H. et al. Myocardial Infarction and coronary deaths in the World Health Organization MONICA Project. Circulation. 1994 July; 90(1): 583-612.
5. Rowlands D.J. Clinical Electrocardiography, New York: Gower Medical Publishing. 1991;114-504.
6. PS Singh et al. Clinical profile and risk factors in acute coronary syndrome. Journal, Indian Academy of Clinical Medicine. 2013April-June; 14(2):130-2.
7. Mohit J Shah et al. A Study of 100 Cases of Arrhythmias in First Week of Acute Myocardial Infarction in Gujarat, A High Risk and Previously Undocumented Population. J Clin Diagn Res. 2014 Jan; 8(1): 58-61.
8. Sangita Rathod et al. Study of various cardiac arrhythmias in patients of acute myocardial infarction: Int Arch Inte Med. 2014 December; 1(4): 32-41.
9. Shimal Khan et al. In-hospital outcome of patients having Acute myocardial infarction with and Without streptokinase; Gomal Journal of Medical Sciences. 2009 July-December; 7(2):96-100.
10. P. Yadav et al. clinical profile & risk factors in acute coronary syndrome. National Journal of Community Medicine. 2010; 1(2):150-152. [PubMed]
11. Siwach S.B. et al. Profile of young acute myocardial infarction in Haryana. J Assoc Physicians India.1998 May; 46(5): 424-6. [PubMed]
12. Kurnald G.S. and D. Pressman. The incidence of arrhythmias in acute myocardial infarction studied with a constant monitoring system. Circulation. 1965 June; 31(6): 834-41.
13. Fluck D.C. et al. Natural history and clinical significance of arrhythmias after acute cardiac infarction. Br Heart J. 1967 March; 29(2):170-9.
14. Datey K.K. A.N. Nathwani and R.M. Shah. 100 Patients of acute myocardial infarction treated in an intensive coronary care unit. J Indian Med Assoc. 1969 May 1;52(9):405-9.
15. Sharma S.K. et al. Incidence and nature of cardiac arrhythmias in cases of acute myocardial infarction in relation to some major coronary risk factors. J Assoc Physicians India. 1986 Jun; 34(6):413-5.
16. Jacob et al. Study of incidence and pattern of arrhythmias complicating acute myocardial infarction correlating it to the site of infarct. Abstract: Joint Annual Conference of Association of Physicians of India and Cardiological Society of India: South Zone.1992;150-98.
17. Julian D.G, P.A. Valentine and G.C. Miller. Disturbances of Rate, Rhythm and conduction in acute myocardial infarction. Am.J. Me. 1964 December; 37(6): 915-27.
18. Bahl A. L., H.B. Lal and P.N. Dharwad. Arrhythmias complicating Acute myocardial infarction. J Indian Med Assoc. 1969 Dec 1;53(11):534-8.
19. Sloman G. and R.J. Prineas. Major Cardiac Arrhythmias in acute myocardial infarction: Implications for longterm survival. Chest 1973 April; 63(4): 513-6.
20. Rajgopalan et al. Acute cardiac infarction treated in an intensive coronary care unit. Indian Heart J. 1972 Apr;24(2):92-100.
21. Jewitt D.E. et al. Incidence and management of Supraventricular arrhythmias after acute myocardial infarction. Lancet.1967 October; 290(7519): 734-8.
22. Subramanyam G. and B. Ramesh Babu. Clinical profile of ischemic heart disease – A study of 2579 cases. J Assoc Physicians India. 1984 Jan;32(1): 48-9.
23. Aggarwal B.L. et al. Prognostic factors in Acute Myocardial infarction. Indian Heart J. 1978 Jul-Aug;30(4):195-9.
24. Kundu S.C. et al. Profile of myocardial infarction among the Railroad workers in Eastern India – A six year study. Indian Heart J. 1982 May-Jun;34(3):151-5.
25. Raman R., V.R. Agarwal and A.K. Gupta. Incidence of atrial arrhythmias in cases of acute MI. J Assoc Physicians India. 1991 Nov;39(11):808.
26. Bandiera A. et al. Supraventricular hyperkinetic arrhythmias in acute myocardial infarct: their prognostic assessment and correlation with the echocardiographic evolution. Cardiologia. 1994 Sep;39(9):633-9.
27. Galcera T.J. et al. Incidence, clinical significance and prognostic significance of Supraventricular tachyarrhythmias in acute myocardial infarction. Rev Esp Cardiol. 1999 Sep;52(9):647-55.
28. Kudenchuk P.J. et al. Comparison of presentation, treatment and outcome of acute myocardial infarction in Men versus Women (The myocardial infarction triage and intervention registry). Am. J. Cardiol. 1996 July; 78(1): 9-14.
29. Nigam P.D. et al. Complications of acute myocardial infarction during first three weeks. Indian Heart J. 1968 Apr;20(2):157-64.
30. Imperial E.S, R. Carballo and H.A. Zimmerman. Disturbances of Rate, Rhythm and conduction in acute myocardial infarction. Am J. Cardiol.1960 January; 5(1):24-9.
31. Passey M.N. et al. Clinical profile of ischemic heart disease (Acute Myocardial Infarction). Indian Heart J. 1986 Jul-Aug;38(4) 334.
32. Gupta M.C, L. Mehta and S.P. Gupta. Clinical profile of acute myocardial infarction with special reference to risk factors – A five year study. J Assoc Physicians India. 1989 Jan;37(1) 55.
33. Awadhi A.H. et al. The prevalence and outcome of ventricular arrhythmias in acute myocardial infarction. Ir J Med Sci. 1990 Apr;159(4):101-3. [PubMed]
34. Maggioni A.P. et al. Prevalence and prognostic significance of ventricular arrhythmias after acute myocardial infarction in the fibrinolytic era. GISSI-2 Results. Circulation. 1993 February; 87(2): 312-22.
35. Wolfe C.L. et al. Polymorphous ventricular tachycardia associated with acute myocardial infarction. Circulation. 1991 October; 84(4): 1543-51. [PubMed]
36. Arun K.N. et al. Retrospective analysis of 500 cases of acute myocardial infarction. J Assoc Physicians India. 1989 Jan;37(1):11. [PubMed]
37. Volpi A. et al. In-hospital prognosis of patients with acute myocardial infarction complicated by primary ventricular fibrillation. N. Engl. J. Med. 1987 July; 317(5): 257-61.
38. Chandrashekhara Rao A.S., S.T. Yavagal and D. Chinnaiah. Conduction disturbances in acute myocardial infarction. Indian Heart J. 1983 Sep-Oct;35(5): 278.
39. Goldberg R.J. et al. Prognosis of acute myocardial infarction complicated by complete heart block (the Worcester Heart Attach Study). Am J. Cardiol. 1992 May; 69(14): 1135-41.
40. Archbold R.A. et al. Frequency and prognostic implication of conduction defects in acute myocardial infarction since the introduction of thrombolytic therapy. Eur Heart J. 1998 Jun;19(6):893-8.
41. Harpaz D. et al. Complete atrioventricular block complicating acute myocardial infarction in the thrombolytic era, SPRINT study group and the Israel Thrombolytic survey group. J. Am. Coll. Cardiol. 1999 November; 34(6): 1721-8.
42. Gupta U.C. and M.L. Kataria. Prognostic significance of arrhythmias after acute myocardial infarction. J Assoc Physicians India. 1992 Dec;40(12):864.
43. Nair M. et al. Conduction disturbance in acute myocardial infarction, incidence and clinical significance. Indian Heart Journal. 1986 Sep-Oct;22 :405-9.
44. Balachandran V. Analysis of intraventricular conduction defects. J Assoc Physicians India. 1998 Jan;46(1) 102.
45. Sgarbossa E.B. et al. Acute myocardial infarction and complete bundle branch block at hospital admission: Clinical characteristics and outcome in the thrombolytic era GUSTO-I Investigations. J. Am. Coll. Cardiol. 1998 January; 31(1): 105-10.
46. Chatterjee S.S. et al. Acute myocardial infarction with conduction disorders. Indian Heart J. 1985 Jul-Aug;37(4):238.
47. Murthy R.S.N. et al. Arrhythmias in acute myocardial infarction, incidence and clinical significance. Indian Heart J. 1984 Sep-Oct;36(5):335.
CITATION
DOI: 10.17511/ijmrr.2015.i7.126
Published: 2015-08-31
How to Cite
1.
S N, kumar GK R, Ranganatha M, Virupakshappa V. Study of Arrhythmias in Acute Myocardial Infarction. Int J Med Res Rev [Internet]. 2015Aug.31 [cited 2024Nov.17];3(7):682-90. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/303
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Original Article
OAI - Open Archives Initiative
