scholarly journals Atrioventricular block as a predictor of major adverse cardiac events in acute coronary syndrome patients

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
H Santos ◽  
M Santos ◽  
I Almeida ◽  
H Miranda ◽  
C Sa ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Cardiac Arrest ◽  
Ventricular Tachycardia ◽  
Blood Transfusion ◽  
Cardiogenic Shock ◽  
Sustained Ventricular Tachycardia ◽  
Mechanical Complication ◽  
Major Hemorrhage

Abstract Funding Acknowledgements Type of funding sources: None. OnBehalf Portuguese Registry of Acute Coronary Syndromes Background Atrioventricular block (AVB) can be a consequence of ischemia in acute coronary syndrome (ACS). Then, its expected, that AVB occurrence is associated with higher rates of major adverse cardiac events (MACE). Objective Evaluate if sustained AVB was a predictor of MACE in ACS hospitalized patients. Methods Multicenter retrospective study, based on the Portuguese Registry of ACS between 1/10/2010-3/05/2020. Patients were divided into two groups: A – patients without AVB, and B – patients that presented AVB. Were excluded patients without a previous cardiovascular history or clinical data regarding AVB occurrence. MACE was defined as re-infarction, congestive heart failure, cardiogenic shock, a mechanical complication of myocardial infarction, completed atrioventricular block, sustained ventricular tachycardia, cardiac arrest, stroke, major hemorrhage, transfusion and hospitalization death. Univariate logistic regression was performed to assess if AVB in ACS patients was a predictor of MACE. Results A total of 32157 patients was analyze and 23774 had information regarding AVB. From the group of patients that presented AVB, 214 (0.9%) had re-infarction, 3847 (16.2%) had congestive heart failure, 1018 (4.3%) had cardiogenic shock, 1069 (4.5%) had atrial fibrillation, 152 (0.6%) had a mechanical complication of myocardial infarction, 354 (1.5%) had sustained ventricular tachycardia, 706 (3.0%) had cardiac arrest, 152 (0.6%) had stroke, 364 (1.5%) had major hemorrhage, 353 (1.5%) had blood transfusion and 928 (3.0%) died. AVB did not predict re-infarction (p = 0.145), congestive heart failure (p = 0.334), atrial fibrillation (p = 0.171), mechanical complication of myocardial infarction (p = 0.465) and cardiac arrest (p = 0.142). Logistic regression revealed that AVB in ACS patients was a predictor of cardiogenic shock (odds ratio (OR) 2.350, p = 0.012, confidence interval (CI) 1.207-4.572), sustained ventricular tachycardia (OR 2.269, p = 0.013, CI 1.187-4.340), stroke (OR 2.231, p < 0.001, CI 1.779-5.852), major hemorrhage (OR 3.863, p < 0.001, CI 2.667-5.558), blood transfusion (OR 4.291, p < 0.001, CI 3.002-6.137) and hospitalization death (OR 2.699, p < 0.001, CI 1.725-4.222). Conclusions AVB in ACS patients predict MACE, namely cardiogenic shock, sustained ventricular tachycardia, stroke, major hemorrhage, blood transfusion and hospitalization death.

scholarly journals Sustained ventricular tachycardia as a predictor of major adverse cardiac events in acute coronary syndrome patients

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
H Santos ◽  
I Almeida ◽  
H Miranda ◽  
M Santos ◽  
C Sa ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Congestive Heart Failure ◽  
Cardiac Arrest ◽  
Ventricular Tachycardia ◽  
Atrioventricular Block ◽  
Sustained Ventricular Tachycardia ◽  
Mechanical Complication ◽  
Coronary Syndrome

Abstract Funding Acknowledgements Type of funding sources: None. OnBehalf Portuguese Registry of Acute Coronary Syndromes Background Sustained ventricular tachycardia (VT) is a frequent rhythm disturbance during an ischemic event like acute coronary syndrome (ACS). VT was frequently associated with worse prognosis, then is expected, that its presence is related to a higher incidence of major adverse cardiac events (MACE). Objective Evaluate if sustained VT was a predictor of MACE in ACS hospitalized patients. Methods Multicenter retrospective study, based on the Portuguese Registry of ACS between 1/10/2010-4/09/2019. Patients were divided into two groups: A – patients without VT, and B – patients that presented VT on the hospitalization. VT was defined as a register or more of the VT with at least 30 seconds. Were excluded patients without a previous cardiovascular history or clinical data. MACE was defined as re-infarction, congestive heart failure, cardiogenic shock, a mechanical complication of myocardial infarction, completed atrioventricular block, sustained ventricular tachycardia, cardiac arrest, stroke and hospitalization death. Univariate logistic regression was performed to assess if VT in ACS patients was a predictor of MACE. Results A total of 29851 patients was analyze and 25725 had information regarding VT. From the group of patients that presented VT, 177 (1.1%) had re-infarction, 2415 (14.1%) had congestive heart failure, 816 (5.0%) had atrial fibrillation, 108 (0.7%) had a mechanical complication of myocardial infarction, 442 (2.7%) had completed atrioventricular block, 458 (2.8%) had cardiac arrest, 101 (0.6%) had stroke and 535 (3.3%) died. VT did not predict re-infarction (p = 0.071), mechanical complication of myocardial infarction (p = 0.979) and stroke (p = 0.500) in ACS hospitalized patients. Logistic regression revealed that VT in ACS patients was a predictor of congestive heart failure (odds ratio (OR) 2.304, p < 0.001, confidence interval (CI) 1.742-3.047), atrial fibrillation (OR 2.078, p < 0.001, CI 1.453-2.973), completed atrioventricular block (OR 1.831, p = 0.012, CI 1.145-2.928), cardiac arrest (OR 15.434, p < 0.001, CI 11.429-20.843) and hospitalization death (OR 6.472, p < 0.001, CI 4.484-9.342). Conclusions VT in ACS patients predict MACE, namely congestive heart failure, atrial fibrillation, completed atrioventricular block, cardiac rest and hospitalization death.

Significance of aborted cardiac arrest and sustained ventricular tachycardia in patients referred for treatment therapy of advanced heart failure

1992 ◽  
Vol 124 (1) ◽  
pp. 123-130 ◽  
Author(s):  
William G. Stevenson ◽  
Holly R. Middlekauff ◽  
Lynne W. Stevenson ◽  
Leslie A. Saxon ◽  
Mary A. Woo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Arrest ◽  
Ventricular Tachycardia ◽  
Advanced Heart Failure ◽  
Sustained Ventricular Tachycardia

Recognition and Management of Cardiac Arrhythmias: Part II. Ventricular Arrhythmias and Bradyarrhythmias

1998 ◽  
Vol 13 (2) ◽  
pp. 68-77
Author(s):  
Simon Chakko ◽  
Raul Mitrani
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Ventricular Tachycardia ◽  
Ventricular Fibrillation ◽  
Cardiac Arrhythmias ◽  
Ventricular Arrhythmias ◽  
Qrs Complex ◽  
Implantable Defibrillators

This review discusses the treatment of ventricular arrhythmias and bradyarrhythmias. Recent studies addressing the management of nonsustained ventricular arrhythmias in patients with congestive heart failure and those recovering from myocardial infarction are discussed. Determination of the origin of wide QRS complex tachycardia is usually possible at the bedside and the diagnostic criteria are provided. Therapy to prevent recurrent ventricular tachycardia or ventricular fibrillation is difficult and controversial. A widely accepted approach based on electrophysiologic testing and implantable defibrillators appears to be the most effective. Recognition and management of common bradyarrhythmias including the indications for pacemakers are discussed.

Myocardial infarction complicating management of congestive heart failure in a dog

1996 ◽  
Vol 32 (1) ◽  
pp. 68-72 ◽  
Author(s):  
TC DeFrancesco ◽  
CE Atkins ◽  
BW Keene
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Ventricular Tachycardia ◽  
Mitral Valve Regurgitation ◽  
Sudden Onset ◽  
Left Ventricular ◽  
Mixed Breed ◽  
Rare Diagnosis ◽  
Echocardiographic Evidence

A 7.5-kg, 10-year-old, spayed female, mixed-breed dog was evaluated for sudden onset of weakness, tachypnea, and an irregular cardiac rhythm. Congestive heart failure secondary to mitral valve regurgitation had been diagnosed six weeks earlier. The dog was stable on furosemide, enalapril, and hydralazine. Complex ventricular tachycardia, altered QRS conformation of sinus complexes, echocardiographic evidence of a hypokinetic left-ventricular free wall, and elevated creatine kinase suggested a diagnosis of myocardial infarction. Despite antiarrhythmic therapy, the dog developed ventricular fibrillation and died 36 hours after admission. Postmortem examination confirmed the myocardial infarction. Although a rare diagnosis in the veterinary patient, myocardial infarction must be considered in the differential diagnosis for sudden onset of weakness, tachypnea, and ventricular tachycardia.

Abstract 153: Rural Systems of Care: Real World Observations and Trends in ST Elevation Myocardial Infarction Patient Characteristics, and Correlations of Arrival Mode to Outcomes

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Scott Mikesell ◽  
Jeffrey Sather ◽  
John Gallagher ◽  
Richard Mullvain ◽  
Tomasz Stys ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Cardiac Arrest ◽  
Systems Of Care ◽  
St Elevation Myocardial Infarction ◽  
Lv Function ◽  
Direct Transfer ◽  
St Elevation ◽  
Transfer Group

Background: Minnesota, North Dakota and South Dakota have been enhancing statewide systems through infrastructure and clinical education regarding ST-elevation myocardial infarction (STEMI) since 2010 in an attempt to equalize access to timely reperfusion in rural areas. A trend in faster time to reperfusion has been observed for STEMI patients who transfer directly to Percutaneous Coronary Intervention (PCI) capable facilities via Emergency Medical Services (EMS) and receive a pre-hospital 12-lead ECG in comparison to those who first present to a non PCI capable facility. This improved time to STEMI recognition and reperfusion may be associated with improved outcomes. Methods: Data was collected via ACTION Registry-GWTG from 2012-2015. The cohort was defined as STEMI patients who received PPCI with interfacility transfer (n=1010) and without (n=376) and who receive a pre-hospital 12-lead ECG (n=1078) and do not (n=308). The association between mode of transport, time to PPCI, and outcomes including LV function, in hospital clinical events, and in-hospital mortality were analyzed by unadjusted association. Multivariable adjustment was performed using covariates from the previously developed and validated ACTION mortality model to determine the independent association between arrival mode and outcomes. Results: The direct transfer group demonstrated shorter cumulative times (79 vs. 145 min., p=<0.001) to coronary reperfusion as compared to the interfacility transfer group. The pre-hospital ECG group experienced a shorter time to transfer (40 vs. 55 min., p=<0.001) to a PPCI center consistent with earlier system recognition and activation for a STEMI patient. The direct transfer and pre-hospital ECG groups had a statistically significant less risk of in-hospital cardiogenic shock, congestive heart failure, cardiac arrest and death as a composite end-point, p=0.011 & <0.001 respectively. During the years of 2012 to 2015, the performance of pre-hospital ECGs has increased. Conclusion: Implementation of Mission Lifeline programming was associated with significantly lower risk of in-hospital shock, congestive heart failure, cardiac arrest and death in STEMI patients presenting via EMS through increased utilization of pre hospital ECG, education, and hospital triage and procedural PPCI streamlining.

scholarly journals Soluble Suppression of Tumorigenicity-2 Levels As Prognostic Marker in Non-ST-segment Elevation Myocardial Infarction

2020 ◽  
Vol 26 (2) ◽  
Author(s):  
Sherly Purnamawaty ◽  
Tenri Esa ◽  
Ibrahim Abd Samad
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Cardiac Arrest ◽  
Cardiogenic Shock ◽  
Prognostic Marker ◽  
Interleukin 1 ◽  
Sudden Cardiac Arrest ◽  
St Segment Elevation ◽  
Coronary Arterial Disease ◽  
Significant Difference

Acute Myocardial Infarction (IMA) is the most severe manifestation of coronary arterial disease, and about 60%-75% ofIMA is NSTEMI. It is known that complications are associated with high mortality rates; therefore, predicting thedevelopment of complications in NSTEMI will help physicians improve risk stratification and determine optimal treatment.Suppression of tumorigenicity-2 (ST2) is a family of interleukin-1 (IL-1) receptors. Ischemia, injury, and myocardial infarctionwill cause cardiomyocytes to release sST2 associated with a worse prognosis. This study aimed to analyze sST2 levels inNSTEMI patients as a prognostic marker. This study used a prospective cohort method performed on NSTEMI patientstreated at Pusat Jantung Terpadu of Dr. Wahidin Sudirohusodo Hospital during March 2019. Forty-two patients wereinvolved as samples. All patients were tested for sST2 levels by immunochromatography and followed up duringhospitalization. Data on the development of heart failure, arrhythmia, cardiogenic shock, sudden cardiac arrest, length ofstay, and outcome were recorded during follow-up. Data were statistically analyzed with Mann-Whitney and Spearman test.The results of the sST2 level in NSTEMI with and without heart failure were 114.09±92.01 ng/mL and 58.94±57.75 ng/mL(p=0.014), respectively. There was no significant difference between sST2 levels in NSTEMI with complications ofarrhythmias, cardiogenic shock, and sudden cardiac arrest compared and patients without those complications (p>0.05).The level of sST2 was significantly higher in NSTEMI patients who passed away (164.05±77.35 ng/mL) than those whosurvived (72.55±73.15 (p=0.027). There was no correlation between sST2 levels and length of stay (p=0.947). It wasconcluded that sST2 levels could be a prognostic marker for NSTEMI, particularly heart failure and outcome.

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