scholarly journals A clinical study of arrhythmias associated with acute myocardial infarction and thrombolysis

2016 ◽  
Vol 5 (1) ◽  
pp. 335 ◽  
Author(s):  
Mayuri A. Mhatre ◽  
Freston M. Sirur ◽  
Deepali R. Rajpal ◽  
Manhar R. Shah
Keyword(s):  
Myocardial Infarction ◽  
Sinus Tachycardia ◽  
Sinus Bradycardia ◽  
Anterior Wall ◽  
Inferior Wall ◽  
Cardiac Enzymes ◽  
Reperfusion Arrhythmias ◽  
Bundle Branch Block ◽  
Patients With Diabetes ◽  
Type Relation

Background: Arrhythmias are a common occurrence in ACS. This study was undertaken to analyze the incidence, frequency and type of arrhythmias in relation to the site of infarction to aid in timely intervention to modify the outcome in MI and to study the significance of Reperfusion arrhythmias.Methods: 100 patients were evaluated. ECG and cardiac enzymes were studied. Arrhythmias complicating AMI in terms of their incidence, timing, severity, type, relation, reperfusion and results were studied.Results: Of the 100 cases, 74% were males and 26% females of which incidence being common between 4th to 7th decades of life. AMI was common in patients with Diabetes and Hypertension (23% each). Incidence of AWMI (58%) is higher than IWMI (40%). Out of all arrhythmias, Ventricular Tachycardia was seen in 24% cases with 50% mortality and preponderance to Antero Lateral Myocardial Infarction. Sinus Tachycardia was seen in 23% of cases with preponderance to Antero Lateral Myocardial Infarction and persistence of Sinus Tachycardia was a prognostic sign, mortality being 22%. Complete Heart Block and Sinus Bradycardia were seen with IWMI, incidence being 53.8% and 100% respectively. Bundle Branch Block was common in AWMI (31%) than IWMI (10%). Among 64 thrombo-lysed cases, 21 had Reperfusion Arrhythmias without any mortality, whereas remaining 43 without Reperfusion Arrhythmias had mortality of 18.6%.Conclusions: According to the study, Tachy-arrhythmias are common with Anterior Wall Myocardial Infarction and Brady-arrhythmias in Inferior Wall Myocardial Infarction. Reperfusion Arrhythmias are a benign phenomenon and good indicator of successful reperfusion.

scholarly journals The Pattern of Cardiac Arrhythmias in Acute ST Elevated Myocardial Infarction and their in-hospital Outcome

2020 ◽  
Vol 16 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Mohammad Khurshadul Alam ◽  
Manzoor Mahmood ◽  
Dipal Krishna Adhikary ◽  
Fakhrul Islam Khaled ◽  
Msi Tipu Chowdhury ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ventricular Tachycardia ◽  
Sinus Tachycardia ◽  
Sinus Bradycardia ◽  
Anterior Wall ◽  
Left Ventricular ◽  
Inferior Wall ◽  
Av Block ◽  
Acute Stemi ◽  
Hospital Outcome

Background: Acute myocardial infarction (AMI) is a major cause of death worldwide with arrhythmia being the most common determinant in the post-infarction period. Identification and management of arrhythmias at an early period of acute MI has both short term and long term significance. Objective: The aim of the study is to evaluate the pattern of arrhythmias in acute STEMI in the first 48 hours of hospitalization and their inhospital outcome. Methods: A total of 50 patients with acute STEMI were included in the study after considering the inclusion and exclusion criteria. The patients were observed for the first 48 hours of hospitalization for detection of arrhythmia with baseline ECG at admission and continuous cardiac monitoring in the CCU. The pattern of the arrhythmias during this period & their in-hospital outcome were recorded in predesigned structured data collection sheet. Result: The mean age was 53.38 ± 10.22 years ranging from 29 to 70 years. Most of the patients were male 42(84%). Majority of the patients had anterior wall ( anterior, antero-septal & extensive anterior) myocardial infarction (54%). Sinus tachycardia in isolation was the most common arrhythmia observed in 36.8% of patients followed by sinus bradycardia (22.8%), ventricular tachycardia (19.3%), ventricular ectopic (12.3%),first degree AV block (5.3%), complete heart block and atrial ectopic 1.7% each. Tachyarrhythmias were more common in anterior wall myocardial infarction, whereas bradyarrhythmias were more common in inferior wall myocardial infarction. Among studied patients, 72% had favourable outcome , followed by acute left ventricular failure 10%, cardiogenic shock & lengthening of hospital stay 8% each and death 2%. Conclusion: The commonest arrhythmias encountered were sinus tachycardia followed by sinus bradycardia, ventricular tachycardia, ventricular ectopic, AV block and atrial ectopic. The incidence of mortality was 2%. University Heart Journal Vol. 16, No. 1, Jan 2020; 16-21

scholarly journals Assessment of arrhythmias in 50 patients of ST-elevation myocardial infarction after thrombolysis: a 24 hour Holter study

2017 ◽  
Vol 4 (3) ◽  
pp. 734 ◽  
Author(s):  
Rishi Rajhans ◽  
M. Narayanan
Keyword(s):  
Myocardial Infarction ◽  
Sinus Tachycardia ◽  
Anterior Wall ◽  
Warning Sign ◽  
Inferior Wall ◽  
Inclusion Criteria ◽  
Global Epidemic ◽  
Coronary Syndrome ◽  
Life Threatening ◽  
St Elevation

Background: Acute coronary syndrome represents a global epidemic. The purpose of this study was to evaluate the incidence of cardiac arrhythmias in acute myocardial infarction (AMI) in the first 24 hours of hospitalization post thrombolysis.Methods: 50 patients of AMI satisfying the inclusion criteria were included for this observational study. Philips Digitrak Holter was attached to the patient's chest for 24 hours and arrhythmias were noted.Results: In the study group 70% of cases were males, rest 30% females. Maximum incidence of AMI was seen between 4th and 7th decade of life. Incidence of diabetes and hypertension were 54% and 66% respectively either alone or in combination. Overall incidence of anterior wall was higher 56% than inferior wall which was 44%. Sinus tachycardia was seen in 54% of cases with higher incidence in anterior wall MI. Among the reperfusion arrhythmias incidence of frequent VPCs was highest with 66% followed by AIVR (42%) and NSVT (30%). AF was found in 3 cases i.e. 6% of which one died. One patient had VF to which she succumbed.Conclusions: It is a matter of debate whether arrhythmias being so common in AMI, should be considered under clinical spectrum or complication of AMI. An increasing belief that less serious arrhythmias may serve as a warning sign for potentially life threatening arrhythmias and timely intervention by drugs, D.C. shock or pacemakers can prevent mortality in these sets of patients.

scholarly journals A clinical study of hemodynamically significant arrhythmias and QTc interval associated with thrombolysed and non thrombolysed acute myocardial infarction patients

2019 ◽  
Vol 6 (5) ◽  
pp. 1548
Author(s):  
Laxmi Mohanani ◽  
Kuldeep Deopujari ◽  
Rangvendra Singh Meena ◽  
T. N. Dubey
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Heart Block ◽  
Sinus Tachycardia ◽  
Complete Heart Block ◽  
Qtc Interval ◽  
Common Occurrence ◽  
Reperfusion Arrhythmias ◽  
Bundle Branch Block ◽  
Type Frequency

Background: Arrhythmias are a common occurrence in acute myocardial infarction. Objectives of this study the hemodynamically significant arrhythmias and QTc interval in thrombolysed and non thrombolysed acute myocardial infarction patients.Methods: Two hundred patients of AMI were enrolled. ECG and cardiac parameters were examined. Arrhythmias and its various parameters like its incidence, type, frequency associated with site of infarction were recorded in thrombolysed and non thrombolysed patients of AMI.Results: AMI was more prevalent in the males (63.3%) and those with 41-50 years of age. Hypertension (35.7%), smoking (34.2%), and diabetes (23.1%) were the major risk factor. Incidence of AWMI (30.7%) is higher than IWMI (25.1%). Out of 200 subjects 130 were thrombolysed. Arrhythmias was observed in total 164 patients while 36 patients has no documentation of arrhythmias. Mean QTc was prolonged (546.88ms vs 404.33ms) in patients documented with arrhythmia compared with those who has no arrhythmia.  Out of all arrhythmias, ventricular tachycardia was seen in 38% cases with 50% mortality and preponderance to antero lateral MI. Sinus Tachycardia was seen in 22% of cases with preponderance to Antero Lateral MI and persistence of Sinus Tachycardia was a prognostic sign, mortality being 12%. Complete Heart Block were seen with IWMI, incidence being 26%. Bundle Branch Block was common in AWMI (31%) than IWMI (10%).Conclusion: Tachyarrhythmias are common with AWMI and bradyarrhythmia’s in IWMI. Reperfusion arrhythmias are a benign phenomenon and good indicator of successful reperfusion.

scholarly journals A study of involvement of different walls of Myocardium in acute Myocardial Infarction in Pakistani population

2016 ◽  
Vol 10 (1) ◽  
Author(s):  
Adil Iqbal ◽  
Shazia Jamil ◽  
Muhammad Amer Rasheed ◽  
Samar Firdous ◽  
Sohail Jamil ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Chest Pain ◽  
Anterior Wall ◽  
Inferior Wall ◽  
Cardiac Enzymes ◽  
Old Patients ◽  
Pakistani Population ◽  
Mortality And Morbidity ◽  
Artery Disease ◽  
Typical Chest Pain

Abstract: Coronary artery disease particularly myocardial infarction remains the leading cause of mortality and morbidity worldwide, There are few modifiable and un-modifiable risk factors of MI. Myocardial infarction is diagnosed on the basis of typical chest pain raised cardiac enzymes and ECG changes, any two of them lead to the diagnosis, In this study old patients of MI, patients with complicated heart disease and the patients who underwent cardiac surgery were excluded, Results: Amongst 50 patients 36(72%) were males and 14(28%) were females. 70% presented with typical chest pain, 48% had anterior wall MI, 32% had anterolateral MI, 16% had anteroseptal MI and 21% had inferior wall MI, whereas 8% had global Ml, Conclusion: Anterior wall is commonest area involved in MI and 70% of all patients presented with typical chest pain and the most important risk factor is smoking.

scholarly journals ACUTE MYOCARDIAL INFARCTION;

2013 ◽  
Vol 20 (03) ◽  
pp. 332-340
Author(s):  
ATIF SITWAT HAYAT ◽  
MUHAMMAD ADNAN BAWANY ◽  
JAWAD AHMED QADRI ◽  
Kiran Khalil
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Heart Block ◽  
Complete Heart Block ◽  
Tertiary Care ◽  
Anterior Wall ◽  
P Value ◽  
Inferior Wall ◽  
Care Hospital ◽  
Significant Difference

Background: Ischemic heart disease is the most common cause for complete heart block (CHB) and sudden death. Heartblocks may occur as complications of acute myocardial infarction (AMI) and are associated with increased mortality. The aim of thisstudy is to determine the frequency of complete heart block (CHB) in acute myocardial infarction at a tertiary care hospital. Place andduration: This study was conducted in Cardiology Department of Liaquat University of Medical and Health Sciences from 1st August2009 to 31st January 2010. Study Design: Cross sectional and descriptive study. Materials and Methods: ST segment elevation equal toor more than 1mm (0.1mv) in two of these leads II, III and aVF. Rise in serum creatinine kinase level (CPK Level) more than twice thenormal value along with CK-MB fraction more than 6% of CPK value. Patients with history of chest pain, shortness of breath, nausea,vomiting and unconsciousness were enrolled in the study. The cardiac enzymes tropinin T was also performed at bed side by venousblood sample. Results: Total of 87 patients were included, prevalence of heart blocks was 27.58%. Anterior wall MI was in 50(57.5%)patients. Of these, 13(54.2%) had complete heart block. Inferior wall MI was in 37(42.5%) cases, of these, 11(45.8%) were found withcomplete heart block. There was no significant difference between anterior wall MI and inferior wall MI with complete heart block (P value> 0.05). Mortality was 2.3% with anterior wall MI. Conclusions: Development of complete heart blocks has important prognosticsignificance. Complete heart block was frequent complication of myocardial infarction.

scholarly journals Influence of Smoking on the Location of Acute Myocardial Infarctions

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Rahel Alemu ◽  
Eileen E. Fuller ◽  
John F. Harper ◽  
Mark Feldman
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Anterior Wall ◽  
The Other ◽  
Myocardial Infarctions ◽  
Inferior Wall ◽  
Arterial Circulation ◽  
The Right

Objective. To determine whether there is an association between smoking and the location of acute myocardial infarctions. Methods. Using a cohort from our hospital and published cohorts from Ireland, Uruguay, and Israel, we calculated odds of having an inferior wall as opposed to an anterior wall acute myocardial infarction among smokers and nonsmokers. Results. In our cohort, there was a higher proportion of smokers than nonsmokers in patients with inferior acute myocardial infarctions than in patients with anterior infarctions. This difference was also present in each of the other cohorts. Odds ratios for an inferior versus an anterior acute myocardial infarction among smokers ranged from 1.15 to 2.00 (median odds ratio, 1.32). When the cohorts were combined (), the pooled odds ratio for an inferior as opposed to an anterior acute myocardial infarction among smokers was 1.38 ( confidence interval, 1.20 to 1.58) (). Conclusions. Cigarette smoking increases the risk of inferior wall acute myocardial infarction more than the risk of anterior wall infarction. Smoking thus appears to adversely affect the right coronary arterial circulation to a greater extent than the left coronary arterial circulation by a mechanism not yet understood.

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