Prognosis and Treatment of Ventricular Arrhythmias Following Myocardial Infarction

Douglas   W.   Laidlaw; Munther   K.   Homoud; Jonathan      Weinstock; N.   A.   Mark Estes III; Mark   S.   Link

Abstract

Ventricular arrhythmias are common in the setting of acute myocardial infarction (AMI). In todays era of reperfusion therapy, anti-arrhythmic medications, and Implantable Cardioverter Defibrillators (ICDs), an understanding of these arrhythmias and the prognosis of patients with these arrhythmias is essential in determining the proper treatment strategy. In general, ventricular arrhythmias occurring in the first 48 hours (early) following admission for AMI do not predict an increased risk of arrhythmias in follow-up. While early sustained ventricular tachycardia and ventricular fibrillation predict increased in-hospital mortality, the medium and long-term mortality is comparable to control populations in most studies. In contrast, ventricular arrhythmias occurring after 48 hours (late) generally predict an increased risk of arrhythmias and sudden cardiac death. This review focuses on the different ventricular arrhythmias which occur in both the early and late stages following myocardial infarction. Special attention is made to the incidence and prognosis of these arrhythmias, and how this relates to current treatment recommendations.

Keywords: Ventricular tachycardia, ventricular fibrillation, myocardial infarction