Incidence of arrhythmias post acute ST-elevation myocardial infarction (MI) in the modern era

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background Current data on arrhythmic risks after acute ST-elevation MI in the modern era of early revascularization in the Asian population are limited. Objective To investigate the incidence of arrhythmias after acute ST elevation MI in a contemporary cohort of Chinese patients in the era of early revascularization and secondary prevention treatment. Method 394 patients admitted with ST elevation MI who under emergency revascularization to our hopsital from 01/01/2018 to 31/12/2019, 88 % male, mean age of men and women 68.07 ± 13.13 and 58.66 ± 12.42 respectively, diabetes mellitus 40%, hypertension 72%, hyperlipidaemia 78%, previous ischaemic heart disease or stroke 10%, smoker 65%, mean follow up of 577 ± 118 days. Pain to needle time (onset of chest pain to primary angioplasty) 4.88 ± 4.60 hours. 130 patients had left ventricular ejection fraction (LVEF) ≤35%, mean LVEF 29.74 ± 5.95 % improved to 39.85 ± 10.13% (p<0.001) after 6 months. Results 12 deaths, 8 non- arrhythmic cause, 1 cardiac arrest due to ventricular fibrillation and 3 of unknown causes. Risk of arrhythmic death/death of unknown cause and atrial fibrillation (AF) is 0.64% vs 2.4% per year respectively. 14 patients developed atrial fibrillation, 11 and 3 in men and women respectively (p=0.433). 7 AF occurred at day 1, 5 at day 2 and 2 at day 3 post MI. Conclusion The arrhythmic risks after acute myocardial infarction in the modern era of early revascularization in the Asian population is lower than previously reported. AF is the commonest arrhythmia post ST elevation MI and 86% occurred within 48 hours may be due to ischaemia and inflammation. Women presented 10 years later than men and there is no significant difference in the incidence of AF.