Muhammad Faisal Khanzada1, Qamar Zaman Qaim Khani1, Zubair Mumtaz1, Mustajab Mujtaba1, Abdul Mueed1, Sajid Ali Shaikh1, Abdul Samad Achakzai1, Syed Haseeb Raza1, Romana Awan1, Tahir Saghir1
1National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
Despite considerable progress in management, coronary artery disease (CAD) remains the leading cause of global deaths. Many of these deaths are attributed to the development of arrhythmias during periods of myocardial infarction and with the introduction of intensive cardiac care unit in the management of acute myocardial infarction (AMI), arrhythmias have become one of the most modifiable complications of AMI. However, there is paucity of local and regional data regarding burden of arrhythmias in AMI patients. Therefore, this study was conducted to determine the frequency of ventricular arrhythmias in patients undergoing primary percutaneous coronary intervention (PCI).
This descriptive cross-sectional study was conducted at the National Institute of Cardiovascular Disease. Consecutive STEMI patients of either gender, between 18 to 70 years of age, and undergoing primary PCI were included in this study. All the patients were kept under observation for 72 hour post-operatively and ventricular arrhythmias such as accelerated idioventricular rhythm (AIVR), frequent PVCs (premature ventricular contractions), non-sustained ventricular tachycardia, sustained ventricular tachycardia, and ventricular fibrillation were recorded.
A total of 343 patients were included with male to female ratio of 3:1 and mean age of 54.72 ±10.75 years. Ventricular arrhythmia were observed in 25.9% (89) of the patients with most commonly observed arrhythmia as AIVR which account for the 33.7% (30/89) of the patient with ventricular arrhythmia followed by non-sustained ventricular tachycardia (25.8%; 23/89), frequent PVCs (20.2%; 18/89), sustained ventricular tachycardia (10.1%; 9/89), and ventricular fibrillation (10.1%; 9/89).
A significant number of patients undergoing primary PCI for STEMI in our population developed ventricular arrhythmia, AIVR was the most common type of arrhythmia. Further studies are needed to identity the factors leading to development of ventricular arrhythmia and preventive measures should be taken to reduce the incidence of life-threatening arrhythmias in these patients.