Incidence of Arrhythmias and Associated Outcome in Patients with Acute ST-Segment Elevation Myocardial Infarction

Abstract

Objective: To determine the incidence of arrhythmias and its association with outcome among hospitalized patients with acute ST- segment elevation Myocardial Infarction (STEMI).

Methodology: A prospective observational study was conducted at department of Cardiology, Liaquat University Hospital, Hyderabad, during one year from December 2021 to November 2022. Patients aged ≥18 years with acute STEMI (clinical presentation, electrocardiographic ST-segment elevation, and elevated cardiac biomarkers), presenting within 24 hours of symptom onset of either gender were included. Proper cardiac monitoring was performed during hospitalization to observed the occurrence of arrhythmias based on continuous ECG monitoring and standard 12-lead ECG recordings. All the cases were followed during hospital stay to evaluate clinical outcomes, including in-hospital mortality, cardiogenic shock, heart failure, and mechanical ventilation requirements. Incidental rate of arrhythmias and their relationship with clinical outcomes were analyzed using SPSS version 23 by applying the appropriate statistical tests and taking p-value of ≤0.05 as significant statistically.

Results: The overall mean age of 210 patients was 51.23±14.22 years, with majority of male patients 54.76% compared to females 45.23%. The overall incidence of arrhythmias was 71.90%. Presence of heart failure was most common amongst all (25.23%) followed by cardiac arrest (3.80%) and mortality (2.38%). However, the heart failure and mortality were significantly more prevalent among acute STEMI patients experienced ventricular arrhythmias as compared to atrial arrhythmias (p-<0.05).

Conclusion: The arrhythmias were observed highly frequent among patients with acute STEMI, specifically ventricular arrhythmias were significantly associated with higher in-hospital complications, including cerebrovascular events and the mortality.