Supraventricular arrhythmia in acute myocardial infarction
Authors:
P. Sedloň
Authors‘ workplace:
Kardiologické oddělení, Interní klinika, 1. LF UK a ÚVN Praha
Published in:
Kardiol Rev Int Med 2010, 12(Supplementum): 17-21
Overview
Supraventricular arrhythmias complicating acute myocardial infarction are a common and usually clinically important problem. The occurrence of certain supraventricular arrhythmias has a significant impact on short- and long-term patient prognosis. Atrial fibrillation is one of the most frequently seen arrhythmias in acute myocardial infarction patients. Especially a new-onset atrial fibrillation a predictor of poorer hospitalization outcome and has an independent and meaningful impact on the future patient prognosis. Long-term effect of antiarrhythmic therapy remains unknown; this therapy is usually indicated only when arrhythmia is associated with severe symptoms or deterioration of the patient’s clinical status. Correction of the risk factors such as hypokalemia, hypoxemia or heart failure is a prerequisite for favourable therapy outcome; amiodaron is widely considered as the first choice antiarhythmic therapy. Early reperfusion therapy reduces the incidence of new-onset atrial fibrillation, most frequently used in the Czech Republic is the primary PCI. Prevention of tromboembolic complications is an essential part of atrial fibrillation treatment. Other supraventricular arrhythmias described in the context of AMI include paroxysmal atrial tachycardia and, rarely, non-paroxysmal atrial tachycardia or multifocal atrial tachycardia. Long-term effect of these arrhythmias on patient prognosis has not been established yet; their onset during AMI could lead to haemodynamic instability and/or worsening of heart failure or myocardial ischemia symptoms. Indication and treatment strategy should be considered individually. Similarly to atrial fibrillation, amiodaron is the first choice antiarrhythmic treatment, if indicated. Thrombembolic event prevention is only rarely needed.
Keywords:
acute coronary syndrome – acute myocardial infarction – supraventricular arrhythmia – atrial fibrillation – prognosis – therapy
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Paediatric cardiology Internal medicine Cardiac surgery CardiologyArticle was published in
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