Frequency Of Arrhythmias In Patients Research Articles

Frequency of Arrhythmias in ST-Segment Elevation Myocardial Infarction Patients During Primary Percutaneous Coronary Intervention (PPCI) Till 48 hours Post PPCI in NICVD

Objective: To determine the frequency of arrhythmias in patients with acute ST-segment elevation myocardial infarction primary percutaneous coronary intervention (PPCI) till 48 hours post PPCI in admitted at national institute of cardiovascular diseases (NICVD), Karachi. Material & Methods: This was a hospital based clinical study conducted at NICVD through convenience sampling technique for the period of 6 months from 1st September 2021 to 31st March, 2022. All the adult (age more than 18 years) male and female, presented with acute ST-segment elevation myocardial infarction, and eligible for PPCI were included in this study. Cardiac arrhythmias during 48 hours post-PPCI were evaluated and documented. SPSS v. 26 was used for data entry and analysis. Results: A total of 285 patients were included for final analysis. The overall mean age ± SD was 56.56±13.07 years. Most of the patients were belongs to age group II (age ≥55 years) as compare to age group I (age <55 years), 50.87% and 49.12%, respectively. The overall incidence of arrhythmias was 16.6% among them most of the arrhythmias were observed during the first 24 hours of PPCI (72.22%). Ventricular arrhythmias were most common as compare to atrial arrhythmias (61.11%). There was an insignificant association observed in relation to gender and incidence of arrhythmias, p 0.236. Patients having age ≥55 were significantly associated with occurrence of arrhythmias, p <0.001. Conclusion: Frequency of cardiac arrhythmias is higher during early hours of after PPCI. Among them, ventricular arrhythmias were more common as compare to atrial arrhythmias. Older patients (age >55 years) were significantly associated with increased incidence of cardiac arrhythmias as compare to younger age group (age <55 years). Keywords: Cardiac arrhythmias, STEMI, primary PCI, time duration, in-hospital incidence, South Asia

ARRHYTHMIAS IN PATIENTS WITH ACUTE CORONARY SYNDROME

Objective: To determine the frequency of arrhythmias in patients with acute coronary syndrome (ACS) in a tertiary care hospital, Karachi, Pakistan.
 Methodology: This cross-sectional study was conducted at cardiology department of a tertiary care hospital of Karachi, Pakistan. A total of 189 consecutive patients of either gender presented with ACS during six months of study period were included. Continuous cardiac monitoring (telemetry) was done to record any arrhythmia within 24 hours of onset of symptoms.
 Results: 189 patients with ACS were included, 152 patients (80.4%) were males with the mean age of 48.23 ± 6.717 years. This included 95 patients (50.3%) with unstable angina, 36 patients (19.1%) with ST elevation myocardial infarction (STEMI), and 58 patients (30.7%) with Non-STEMI. Arrhythmias were seen in 39 patients (20.6%), most commonly observed type of arrhythmia was premature ventricular contractions (12), atrial fibrillation (nine), ventricular tachycardia (seven), and ventricular fibrillation (five).
 Conclusion: Arrhythmias were reported in 39 patients from the total, accounting for 20.63% of the entire population. The incidence of cardiac arrhythmia was more in the age group 40-60 years and male population.

ARRHYTHMIAS IN PATIENTS WITH ACUTE CORONARY SYNDROME

Objective: To determine the frequency of arrhythmias in patients with acute coronary syndrome (ACS) in a tertiary care hospital, Karachi, Pakistan. Methodology: This cross-sectional study was conducted at cardiology department of a tertiary care hospital of Karachi, Pakistan. A total of 189 consecutive patients of either gender presented with ACS during six months of study period were included. Continuous cardiac monitoring (telemetry) was done to record any arrhythmia within 24 hours of onset of symptoms. Results: 189 patients with ACS were included, 152 patients (80.4%) were males with the mean age of 48.23 ± 6.717 years. This included 95 patients (50.3%) with unstable angina, 36 patients (19.1%) with ST elevation myocardial infarction (STEMI), and 58 patients (30.7%) with Non-STEMI. Arrhythmias were seen in 39 patients (20.6%), most commonly observed type of arrhythmia was premature ventricular contractions (12), atrial fibrillation (nine), ventricular tachycardia (seven), and ventricular fibrillation (five). Conclusion: Arrhythmias were reported in 39 patients from the total, accounting for 20.63% of the entire population. The incidence of cardiac arrhythmia was more in the age group 40-60 years and male population.

The impact of continuous positive airway pressure on cardiac arrhythmias in patients with sleep apnea.

Background:Obstructive sleep apnea (OSA) can lead to cardiac complications: brady and tachyarrhythmias and sudden cardiac death. Continuous positive airway pressure (CPAP) is the gold standard for the treatment of OSA. The present study aims to demonstrate the efficiency of CPAP in the treatment of cardiac arrhythmias in patients with OSA. The study also recorded the frequency of arrhythmias in patients with untreated OSA and assessed the association between the severity of OSA and the occurrence of arrhythmias.Materials and Methods:This is a prospective cohort study. Ninety-three patients with OSA were included, aged 60 (58–64) years, with female/male sex ratio of 1:4. They were subjected simultaneously to home respiratory polygraphy examination and Holter electrocardiogram monitoring, in two different stages: at diagnosis and at the 3-month checkup after CPAP treatment. The presence of supraventricular and ventricular arrythmias was noted. Respiratory parameter values were also recorded.Results:Statistically significant decrease in the occurrence of supraventricular (P < 0.001) and ventricular extrasystoles (P < 0.001), atrial fibrillation (AF) (P = 0.03), nonsustained ventricular tachycardia (NSVT) (P = 0.03), and sinus pauses (P < 0.001) was observed 3 months after treatment with CPAP, compared with baseline. The apnea–hypopnea index (AHI) was correlated with the ventricular extrasystoles (r = 0.273; P = 0.008). The ejection fraction of the left ventricle was inversely correlated with the episodes of NSVT (r = −0.425; P < 0.001). AF was associated with the longest apnea (r = 0.215; P = 0.04). Cardiac activity pauses were correlated with AHI (r = 0.320; P = 0.002), longest apnea (r = 0.345; P = 0.01), and oxygen desaturation index (r = 0.325; P = 0.04).Conclusion:The prevalence of cardiac arrhythmias in patients with OSA was reduced after 3 months of CPAP therapy. Cardiac arrhythmias were correlated with the severity of OSA.

Does cardiac rhythm monitoring in patients with elevated troponin levels lead to changes in management?

We sought to identify the frequency of arrhythmias in patients with elevated cardiac troponin levels and without ST-segment elevation myocardial infarction or a primary arrhythmia, and to determine whether detection of an arrhythmia leads to management changes. A review of 1381 consecutive patients admitted from the emergency department for rhythm monitoring with an elevated cardiac troponin T (cTnT) level was performed. Patients admitted to an intensive care unit and those with an initial primary arrhythmia were excluded. Troponin values were obtained on admission, at 3 hours and at 6 hours. Electronic medical records and all rhythm recordings were reviewed for documentation of an arrhythmia and any changes in management. An arrhythmia was detected in 26% of the 330 patients who met the inclusion criteria. Those with arrhythmias had higher rates of coronary artery disease and prior percutaneous coronary intervention ( p = 0.02 and p = 0.01, respectively). Those with arrhythmias had higher mean cTnT values compared to those without arrhythmias ( p = 0.02 at 3 hours and p = 0.006 at 6 hours) even after controlling for a discharge diagnosis of acute coronary syndrome. Changes in management in response to the detection of arrhythmias were infrequent (6.3%) and usually included only changes in medication doses. Patients admitted with an elevated cTnT level to a non-intensive care unit rhythm-monitored bed without ST-segment elevation myocardial infarction or primary arrhythmia have a high incidence of arrhythmias; however, changes in management are infrequent.

Significance of serum magnesium levels in reference to acute myocardial infarction and role of intravenous magnesium therapy in prevention of cardiac arrhythmias following myocardial infarction

Introduction: The role of magnesium in treating arrhythmias due to acute myocardial infarction (AMI) has been controversial. Most of the studies have reported a significant reduction in the mortality and frequency of arrhythmias in patients with AMI, who received magnesium therapy, in comparison with control with AMI, who did not receive magnesium treatment. We, therefore, decided that we would evaluate the effect of intravenous magnesium supplement therapy in patients admitted for acute myocardial infarction and if this would be helpful in reducing the morbidity and mortality in patients. Materials and Methods: The study was carried out as a prospective randomized controlled trial of magnesium therapy in acute myocardial infarction. Hundred patients with acute myocardial infarction were randomly divided into two groups of 50 patients each, one for trial and other for placebo therapy. Control group consisted of 20 healthy volunteers of the same age group. All of the 100 patients included in the study had reported within 12 hours of the onset of chest pain. Blood samples for estimation of serum magnesium were taken on admission and on days 2 and 5. Results: The mean age in the Group I and II were 59.52 years ± 15.03 and 59.14 years ± 13.41, respectively. Serum magnesium level on admission was higher in the healthy controls than in the patients of acute myocardial infarction ( P P Conclusions: Intravenous magnesium is a safe and effective method of reducing the frequency of arrhythmias and mortality following the acute myocardial infarction. Magnesium therapy reduces the incidence of arrhythmias and mortality even in the absence of demonstrable magnesium deficiency.

Study of the safety and efficacy of ACE inhibitors and their effects on 24-hour electrocardiographic monitoring in the treatment of moderate-to-severe heart failure: An interim analysis

S ince their introduction, angiotensin-converting enzyme (ACE) inhibitors have become a significant new treatment for congestive heart failure (CHF) and a considerable amount of evidence has been accumulated to indicate that ACE inhibitors can reduce the frequency of arrhythmias in patients with CHF. However, the mechanism by which this effect on arrhythmias is achieved is not yet clear. The following describes an interim analysis of a study comparing the efficacy and tolerability of lisinopril and enalapril in the treatment of moderate-to-severe CHF. The first 156 patients who completed or withdrew from the study are included with treatment codes unbroken. The emphasis of this interim analysis is placed on describing the patient population and making comparisons over the course of the study. The target for recruitment to the study will be 250 patients and the full results are expected mid-1992.

Arrhythmias in chronic pulmonary disease.

Arrhythmias often complicate the course of patients with severe respiratory disease; the frequency of arrhythmias in patients with this condition approaches that seen with acute myocardial infarction. No one rhythm disturbance predominates, but rapid atrial and ventricular rhythms are characteristic. In the setting of acute respiratory failure, several conditions may predispose to arrhythmias. Hypoxemia, a serum pH that is too high or too low, and a low serum potassium may produce arrhythmias by disturbing the myocardial cellular milieu. Drugs such as digitalis, epinephrine, and theophylline may also act as myocardial irritants. The first step in therapy is to careful examination, it is helpful to note the specific effect of the arrhythmia on the patient. Some rhythm disturbances are well tolerated, while others are associated with serious problems in ventilation and perfusion. In many cases the control of respiration, correction of pH and electrolyte imbalance, and provision of bronchial hygiene will restore a normal sinus rhythm. Such measures are essential even when antiarrhythmic drugs or cardioversion are needed.