A Prospective Study of Risk of Arrythmias in Patients with Myocardial Infarction in a Tertiary Care Center.

UNLABELLED: Acute Coronary Syndrome (ACS) is an emerging epidemic in India. Conduction blocks occur in about 15-20% of patients with acute MI, studies have shown that arrhythmias are important predictors of poor outcome in patients with ACS and are associated with higher in hospital mortality.In this study an attempt is made to know the association of arrhythmias in patients of acute MI. In acute MI sudden cardiac death can occurs due to arrhythmias.

MATERIAL: A Prospective clinical study consisting of 100 patients of acute coronary syndrome were taken to determine the occurrence of arrhythmia. All cases of ACS admitted in Mandya Institute of medical Sciences were taken in the study. All cases of ACS with age, less than 50yrs and more than 18yrs, admitted in MIMS, Mandya were studied.ECG at the time of admission, fourth hourly on day of admission, daily morning and as whenever needed, cardiac enzymes studies, and echocardiography were done. The patients were observed for conduction defects for 5 days after the admission or until they stay in the hospital whichever was earlier.

INCLUSION CRITERIA: Patients of acute myocardial infarction with age more than 18yrs and less than 50yrs, admitted to MIMS, Mandya.

EXCLUSION CRITERIA: Previously known cases of conductions defects. -Patients on drugs, which may cause conductions defects, like Beta blockers, calcium channel blockers and Digoxin. -All cases with conduction defects due to other documented causes like structural abnormalities or electrolyte disturbances were excluded from the study. -Patient's with previous history of IHD.

OBSERVATION: A total of 100 patients are taken, which included 56 males and 44 females. In this present study out of 100 patients, 78 patients had arrhythmias, of that 40% were females and 38% were males. In this study 56% of arrhythmia occurred during the 1st hour, 24% of patients had arrhythmias during 12-24 hours, 19% of patients had arrhythmias after 24 hours. The most common type of arrhythmia was ventricular premature complexes(24.36%) followed by sinus tachycardia(16.67%) and atrial fibrillation(15.38%). The least common type of arrhythmia was 1st degree heart block (2.56%) in this study. Among the type of ACS, ST elevation MI was associated with increased risk of arrhythmia (71%), followed by Non ST-Elevation MI (23%) and Unstable angina (6%).

CONCLUSION: Arrhythmias associated with ACS are common, and may be related to more complicated comorbidity and more severe impairment of myocardium, and lead to a poorer prognosis. More attention should be paid to these patients to improve their treatment and prognosis.