Author + information
- Ashwin Lysander1
Ventricular tachycardia (VT) is a life-threatening arrhythmia complicating acute coronary syndromes more so in ST-elevation myocardial infarction, and if left untreated, causes significant mortality and morbidity. We undertook this study to estimate the incidence of ventricular tachycardia in acute coronary syndromes and study the clinical profile of these patients.
This is a single center observational study conducted over a period of one year in a tertiary care institution. 473 cases of acute coronary syndrome were reported in one year. Among the 473 patients studied, 297 were males and 176 were females. 289 patients presented with STEMI, 64 had NSTEMI and 120 had unstable angina.
All the patients were monitored continuously for 5 days using Philips Heart start XL cardiac monitor which is equipped with automatic recording of arrhythmias. Wherever possible 12 lead ECGs were taken to record the arrhythmias.
Out of the 289 patients presenting with ST elevation myocardial infarction 194 patients received thrombolytic therapy. The rest presented beyond a window period of 12 hours.
|Acute coronary syndrome||Number||Ventricular tachycardia||%||Mortality|
|STEMI (Not thrombolysed)||95||3||3.15||14|
|Acute coronary syndrome||Ventricular tachycardia||24 hrs||48 hrs||72hrs||96hrs||120hrs|
|STEMI (Not thrombolysed)||3||2||1||0||0||0|
|Acute coronary syndrome||Ventricular tachycardia||Anterior wall MI||Inferior wall MI|
As seen from the above tables, ventricular tachycardia occurred in about 2% of cases of STEMI who were thrombolysed and in 3.15% of patients with STEMI who were not thrombolysed which is a huge 153% rise in the incidence of VT. 1.56% and 0.83% of NSTEMI and unstable angina patients suffered VT respectively.
Also from the above tables, it is evident that VT occurred predominantly in anterior wall myocardial infarction compared to that of inferior wall myocardial infarction. The majority of the episodes of ventricular tachycardia occurred within the first 24 hours of presentation. The mortality in the thrombolysed group was lesser than that of the not thrombolysed group.
Thus this study also highlights the importance of early thrombolysis in reducing the rates of arrhythmias and death due to myocardial infarction.