COMPARATIVE FREQUENCY OF ARRHYTHMIAS IN INFERIOR AND ANTERIOR WALL MYOCARDIAL INFARCTION

Abstract

This study was aimed to compare the prevalence and the nature of arrhythmias in patients of acute anterior wall ST-elevation myocardial infarction (AWMI) and inferior wall ST-elevation myocardial infarction (IWMI) during their stay in the hospital. It was carried out at National Hospital and Medical Center, Lahore, a tertiary care setup. Adult patients >15 years of age with ST-elevation MI of either anterior (AWMI) or inferior (IWMI) territory, whereas the exclusion criteria included the presence of preexisting cardiomyopathies, channelopathies, or electrolyte disturbances. The cardiac rhythm was observed continuously via cardiac monitors, arrhythmias if detected, were confirmed and documented with the help of 12-lead ECG. The statistical analysis was performed in SPSS software, version 20. A substantial percentage of patients (70 per cent) revealed to have arrhythmias; the frequency was significantly higher in AWMI (62.9 per cent) than in IWMI cases (37.1 per cent). The most prevalent arrhythmias was premature ventricular contractions PVCs (51.4%) followed by ventricular tachycardia VT (17.1%) being the second most observed arrhythmia. High degree AV block was more common in IWMI (10 percent) and Wenckebach AV block occurred only in IWMI (7.1percent). Additional less commonly arrhythmias included atrial fibrillation (4.3%), and ventricular fibrillation (2.9%). AWMI had more arrhythmias compared to IWMI and PVCs, VT remained the most common ones. AV blocks were more frequent in IWMI. Such results highlight the importance of preemptive monitoring and management plans that should be dependent on the location of infarcts. Upon these observations it is desirable that further large-scale study be conducted.