A study of arrhythmias during the first 48 hours of acute myocardialinfarction in rural population

Abstract

Aim : To study the patterns and course of electro cardiographic rhythm changes during and within 48 hours in patients of acute myocardial infarction patients admitted in tertiary care hospital.Materials and Methods : This prospective study was undertaken in 100 patients. Patients of AMI based on the Third Universal Definition of Myocardial Infarction with arrhythmia within first 48 hours from initial symptoms, of age above 18 years of any gender and will be participate by signing written informed consent were included in the study. Patients previously known cases of conduction blocks, known cases of congenital heart block and congenital QT prolongation syndrome and whose death occurred within 48 hours were excluded from the study. The personal history, diagnosis, relationship of arrhythmia with site of AMI, timing was recorded.Results : Among 100 cases, maximum incidence was found after 5th decade. Incidence of arrhythmias was higher in males (71%). Anterior wall infarcts (49%) were more common than inferior wall (39%). Ventricular Premature Contraction (VPC) (20.3%) was the commonest arrhythmia. Of the 79 patients who experienced arrhythmia, a large number of arrhythmias resolved spontaneously (55.6%) while other cases were terminated pharmacologically (22.7%) or electrically (8.8%) whereas 12.6 % of the arrhythmias persisted in spite of treatment. There was no significance association of history of smoking, drinking, hypertension and diabetes with occurrence of arrhythmia. However, there was significant increase in arrhythmia in thrombolysed cases. Conclusion: Older males are affected by AMI more commonly. Arrhythmias are more common in anterior wall with Ventricular Premature Contraction as the most common arrhythmia. Thrombolysis is associate with higher occurance of arrhythmia. While most arrhythmias can resolve spontaneously, intervention is needed in many cases.