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 CLINICAL OUTCOME OF PATIENTS ADMITTED WITH ACUTE ANTERIOR VERSUS ACUTE INFERIOR WALL MYOCARDIAL INFARCTION

2021 ◽  
Vol 70 (Suppl-4) ◽  
pp. S892-96
Author(s):  
Moazzam Khan ◽  
Imtiaz Ahmed Khan ◽  
Naseer Ahmad Samore ◽  
Javeria Kamran ◽  
Anam Fatima Janjua ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ventricular Tachycardia ◽  
Clinical Outcome ◽  
Cardiogenic Shock ◽  
Troponin I ◽  
Armed Forces ◽  
Anterior Wall ◽  
Left Ventricular ◽  
Inferior Wall ◽  
Anterior Wall Myocardial Infarction

Objective: To determine the clinical outcome of patients admitted with acute anterior versus acute inferior wall myocardial infarction. Study Design: Comparative cross-sectional study. Place and Duration of Study: The study was conducted in emergency departments and adult cardiology wards of Armed Forces Institute of Cardiology/National Institute of Heart Diseases, from Aug 2019 to Nov 2019. Methodology: This study was conducted on 340 patients (208 patients with Anterior wall myocardial infarction and 132 patients with inferior wall MI who presented with Acute ST-Elevation MI) to emergency department of Armed Forces Institute of Cardiology/National Institute of Heart Disease during specified period. Outcome was calculated using Electrocardiogram, Two-dimensional transthoracic echocardiogram, Troponin-I, baseline investigations and coro angiography Data was entered and analyzed with SPSS-23. Results: Mean age was 59.38 ± 12.91 years in each group. In clinical symptoms chest pain was highest n=255 (71.4%) followed by diaphoresis 55 (15.4%) and breathlessness 51 (14.3%). The most common complications in patients with inferior wall MI were brady arrhythmia 8 (2.3%) whereas left ventricular failure 41 (12.1%) was more prevalent in patients with anterior wall MI after TVCAD. The results of cardiogenic shock 5 (1.5%),ventricular tachycardia 3 (0.8%) in inferior wall myocardial infarction were comparative to the results of cardiogenic shock 18 (5.3%) ventricular tachycardia 2 (0.5%) in anterior wall myocardial infarction. The number of stable patients was 91 (43.7%) in Anterior wall myocardial infarction and 51 (38.6%) in inferior wall MI. Conclusion: The study shows the comparative clinical outcome of anterior wall myocardial infarction versus inferior wall myocardial infarction.

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 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 Clinical Features, Treatment Choices and in-Hospital Outcome of Patients with ST-Segment Elevation Myocardial Infarction in Eastern Region of Nepal: A Hospital-Based Study

2019 ◽  
Vol 8 (2) ◽  
pp. 37-41
Author(s):  
Rajesh Nepal ◽  
Sahadeb Prasad Dhungana
Keyword(s):  
Myocardial Infarction ◽  
Medical Therapy ◽  
Clinical Characteristics ◽  
Treatment Options ◽  
Inferior Wall ◽  
Primary Pci ◽  
Duration Of Symptoms ◽  
Female Ratio ◽  
Acute Stemi ◽  
Hospital Outcome

Background: Patients with Acute ST-elevation myocardial infarction (STEMI) have different modes of presentation, treatment options and outcomes which vary across the different population. There is a paucity of data about the clinical characteristics of acute STEMI from the eastern part of Nepal. Our study aimed to assess the clinical characteristics and in-hospital outcome of patients with acute STEMI at a tertiary care center of the eastern part of Nepal. Materials and Methods: This is a descriptive cross-sectional study on 214 patients who presented in the emergency room or coronary care unit of Nobel Medical College Teaching Hospital from August 2018 to July 2019. Demographic features, risk factors, duration of symptoms before presentation, different treatment options offered and the in-hospital outcome were noted. Results: The male to female ratio was 2.14. The most common symptom was chest pain (97.0%) followed by sweating 78.0%, breathlessness 29.0%, nausea or vomiting 24.8 %, etc. The most common regional territory involved was the anterior wall (48.1%) followed by the Inferior wall (42.5 %), posterior wall (5.1 %). The majority (71.3%) presented within 12 hours after symptom onset.  Hypertension was the most frequent (40.2%) risk factor followed by Smoking (39.7%), diabetes mellitus (35.0%) and dyslipidemia (34.6%). Among patients eligible for primary PCI - 76.6% underwent PCI, 22.0% were managed conservatively. Total mortality among patients managed with primary PCI was 3% as compared to medical therapy (14.8%). Heart failure prevalence was less with primary PCI (12.1%) compared to medical therapy (29.6%). Conclusion: The majority of patients presented with typical symptoms in a reasonably early period (12 hrs) and the in-hospital outcome was better with primary PCI.  Hence, efforts should be made to offer primary PCI to the majority of patients in the peripheral part of our country.

scholarly journals Prognostic Significance of “In hospital Arrythmias” in Acute Myocardial Infarction

2004 ◽  
Vol 3 (3) ◽  
pp. 61-62
Author(s):  
Y Verma ◽  
CM Singh ◽  
R Gupta ◽  
VK Sharma ◽  
G Singh ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Prognostic Significance ◽  
Anterior Wall ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Inferior Wall ◽  
Cardiac Events ◽  
Ventricular Ejection Fraction

Arrythmias after Acute myocardial infarction (AMI) have a prognostic value, in addition to the morbidity it involves. To evaluate the significance of arrythmias 50 patients of AMI (37-Male, 13-Female) in the age group of 35-72 years were studies, Out of these 50 cases, 48% (n=24) had anterior wall myocardial infarction, 30% (n-15) had inferior wall myocardial infarction, 22% (n=11) had interior+Right Ventricular wall myocardial infarction. Thrombolysis was done in 56% (n=28) patients fulfilling inclusion criteria. Left ventricular ejection fraction (LVEF) of less than 50% was present in 24% (n=12) patients. 50% patients (n=25) experienced “In hospital arrythmias” and 28% (n=7) patients had cardiac events in 6 months follow up. In the group without “In hospital arrythmias" 60% (n-15) developed follow up events. Out of 12 patients with LVEF of less than 50% (n=12), 8 patients (66%) developed “In Hospital arrythmias” and 10 patients (83%) developed subsequent morbid cardiac events.

scholarly journals Mobitz Type 1 Second‐degree Atrioventricular Block in Anterior Wall Myocardial Infarction and Its Reversal with Successful PCI of Left Anterior Descending Artery – An Extremely Rare Association

2019 ◽  
pp. 1-5
Author(s):  
Gurkirat Singh ◽  
Hemant Khemani ◽  
Shakil Shaikh ◽  
Narender Omprakash Bansal
Keyword(s):  
Myocardial Infarction ◽  
Atrioventricular Block ◽  
Anterior Wall ◽  
Inferior Wall ◽  
Av Block ◽  
Left Anterior Descending Artery ◽  
Anterior Wall Myocardial Infarction ◽  
Mobitz Type ◽  
Second Degree

Arrhythmias can complicate the course of patients with ST-elevation myocardial infarction. These arrhythmias can include both tachyarrhythmias and bradyarrhythmias. Tachyarrhythmias range from Ventricular premature complexes to life-threatening ventricular tachycardia/ fibrillation. Bradyarrhythmias range from sinus bradycardia to complete heart block. These arrhythmias have the ability to provoke hemodynamic consequences and increase mortality. Tachyarrhythmias are more common with Anterior wall myocardial infarction and bradyarrhythmias are more common with Inferior wall myocardial infarction. We report a case of Mobitz Type 1 (Wenkebach) second-degree atrioventricular block in a patient with Anterior wall myocardial infarction. Angiography showed a significant lesion in Left anterior descending artery, after the first septal and diagonal branch. After the successful percutaneous coronary intervention, this second degree AV block reverted to first degree AV block. To the best of our knowledge, there is no case report describing this association separately.

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