Skip to main content
NCBI home page
British Heart Journal logoLink to British Heart Journal
. 1975 Jun;37(6):598–603. doi: 10.1136/hrt.37.6.598

Evaluation of arrhythmias in the late hospital phase of acute myocardial infarction compared to coronary care unit ectopy.

L A Vismaria, A N DeMaria, J L Hughes, D T Mason, E A Amsterdam
PMCID: PMC482842  PMID: 50075

Abstract

To evaluate the prevalence and nature of arrhythmias during the entire three-week period in hospital after myocardial infarction, the results of coronary care unit monitoring (initial 3 to 5 days) were compared with continuous 8-hour portable monitoring during the ambulatory phase (second and third weeks) in 83 consecutive survivors. Arrhythmias were detected in 84.3 per cent (70/83) of patients while in the coronary care unit and in 85.5 per cent (71/83) during hospital stay after the coronary care unit. Ventricular ectopic depolarizations were classified as complicated (multifocal, paired, R on T, or five or more a minute) or uncomplicated. Importantly, the high frequency of complicated ventricular extrasystoles and tachycardia persisted during the entire period in hospital (early 34.9% and late 42.5% of all patients). However, only 16.9 per cent (14/83)had these ventricular arrhythmias during both coronary care unit and ward monitoring. Thus, the absence of complicated ventricular ectopic depolarization and ventricular tachycardia in the coronary care unit did not exclude their subsequent occurrence in the majority of the large number of patients with late hospital complicated ventricular ectopy.

Full text

PDF
598

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aranaga C. E., Mower M. M., Staewen W. S., Tabatznik B. Eight-hour electrocardiogram: technique and clinical application. Br Heart J. 1967 May;29(3):345–351. doi: 10.1136/hrt.29.3.345. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Case R. B., Nasser M. G., Crampton R. S. Biochemical aspects of early myocardial ischemia. Am J Cardiol. 1969 Dec;24(6):766–775. doi: 10.1016/0002-9149(69)90465-2. [DOI] [PubMed] [Google Scholar]
  3. Chiang B. N., Perlman L. V., Fulton M., Ostrander L. D., Jr, Epstein F. H. Predisposing factors in sudden cardiac death in Tecumseh, Michigan. A prospective study. Circulation. 1970 Jan;41(1):31–37. doi: 10.1161/01.cir.41.1.31. [DOI] [PubMed] [Google Scholar]
  4. Day H. W., Averill K. Recorded arrhythmias in an acute coronary care area. Dis Chest. 1966 Feb;49(2):113–118. doi: 10.1378/chest.49.2.113. [DOI] [PubMed] [Google Scholar]
  5. DeSanctis R. W. Arrhythmias in myocardial infarction. Del Med J. 1971 Aug;43(8):209–215. [PubMed] [Google Scholar]
  6. Fluck D. C., Olsen E., Pentecost B. L., Thomas M., Fillmore S. J., Shillingford J. P., Mounsey J. P. Natural history and clinical significance of arrhythmias after acute cardiac infarction. Br Heart J. 1967 Mar;29(2):170–189. doi: 10.1136/hrt.29.2.170. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. GILSON J. S., HOLTER N. J., GLASSCOCK W. R. CLINICAL OBSERVATIONS USING THE ELECTROCARDIOCORDER-AVSEP CONTINUOUS ELECTRODIOGRAPHIC SYSTEM. TENTATIVE STANDARDS AND TYPICAL PATTERNS. Am J Cardiol. 1964 Aug;14:204–215. doi: 10.1016/0002-9149(64)90134-1. [DOI] [PubMed] [Google Scholar]
  8. Goble A. J., Sloman G., Robinson J. S. Mortality reduction in a coronary care unit. Br Med J. 1966 Apr 23;1(5494):1005–1009. doi: 10.1136/bmj.1.5494.1005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Grace W. J. The mobile coronary care unit and the intermediate coronary care unit in the total systems approach to coronary care. Chest. 1970 Oct;58(4):363–368. doi: 10.1378/chest.58.4.363. [DOI] [PubMed] [Google Scholar]
  10. HOLTER N. J. New method for heart studies. Science. 1961 Oct 20;134(3486):1214–1220. doi: 10.1126/science.134.3486.1214. [DOI] [PubMed] [Google Scholar]
  11. Hagstrom R. M., Billings F. T., Jr, Ball C. O., Meneely G. R. The risk of sudden death following myocardal infarction. Arch Environ Health. 1967 Oct;15(4):450–454. doi: 10.1080/00039896.1967.10664946. [DOI] [PubMed] [Google Scholar]
  12. Hinkle L. E., Jr, Meyer J., Stevens M., Carver S. T. Tape recordings of the ECG of active men. Limitations and advantages of the Holter-Avionics instruments. Circulation. 1967 Nov;36(5):752–765. doi: 10.1161/01.cir.36.5.752. [DOI] [PubMed] [Google Scholar]
  13. James T. N. Sudden death related to myocardial infarction. Circulation. 1972 Jan;45(1):205–214. doi: 10.1161/01.cir.45.1.205. [DOI] [PubMed] [Google Scholar]
  14. Jelinek M. V., Lohrbauer L., Lown B. Antiarrhythmic drug therapy for sporadic ventricular ectopic arrhythmias. Circulation. 1974 Apr;49(4):659–666. doi: 10.1161/01.cir.49.4.659. [DOI] [PubMed] [Google Scholar]
  15. Jennings R. B. Early phase of myocardial ischemic injury and infarction. Am J Cardiol. 1969 Dec;24(6):753–765. doi: 10.1016/0002-9149(69)90464-0. [DOI] [PubMed] [Google Scholar]
  16. Killip T., 3rd, Kimball J. T. Treatment of myocardial infarction in a coronary care unit. A two year experience with 250 patients. Am J Cardiol. 1967 Oct;20(4):457–464. doi: 10.1016/0002-9149(67)90023-9. [DOI] [PubMed] [Google Scholar]
  17. Kotler M. N., Tabatznik B., Mower M. M., Tominaga S. Prognostic significance of ventricular ectopic beats with respect to sudden death in the late postinfarction period. Circulation. 1973 May;47(5):959–966. doi: 10.1161/01.cir.47.5.959. [DOI] [PubMed] [Google Scholar]
  18. Kurien V. A., Oliver M. F. A metabolic cause for arrhythmias during acute myocardial hypoxia. Lancet. 1970 Apr 18;1(7651):813–815. doi: 10.1016/s0140-6736(70)92412-8. [DOI] [PubMed] [Google Scholar]
  19. Lovell R. R., Prineas R. J. Mechanisms of sudden death and their implications for prevention and management. Prog Cardiovasc Dis. 1971 Mar;13(5):482–494. doi: 10.1016/0033-0620(71)90013-2. [DOI] [PubMed] [Google Scholar]
  20. Lown B., Fakhro A. M., Hood W. B., Jr, Thorn G. W. The coronary care unit. New perspectives and directions. JAMA. 1967 Jan 16;199(3):188–198. [PubMed] [Google Scholar]
  21. Lown B., Wolf M. Approaches to sudden death from coronary heart disease. Circulation. 1971 Jul;44(1):130–142. doi: 10.1161/01.cir.44.1.130. [DOI] [PubMed] [Google Scholar]
  22. Marshall R. M., Blount S. G., Jr, Genton E. Acute myocardial infarction. Influence of a coronary care unit. Arch Intern Med. 1968 Dec;122(6):472–475. doi: 10.1001/archinte.122.6.472. [DOI] [PubMed] [Google Scholar]
  23. Moss A. J., Schnitzler R., Green R., Decamilla J. Ventricular arrhythmias 3 weeks after acute myocardial infarction. Ann Intern Med. 1971 Dec;75(6):837–841. doi: 10.7326/0003-4819-75-6-837. [DOI] [PubMed] [Google Scholar]
  24. Mounsey P. Intensive coronary care. Arrhythmias after acute myocardial infarction. Am J Cardiol. 1967 Oct;20(4):475–483. doi: 10.1016/0002-9149(67)90025-2. [DOI] [PubMed] [Google Scholar]
  25. SPANN J. F., Jr, MOELLERING R. C., Jr, HABER E., WHEELER E. O. ARRHYTHMIAS IN ACUTE MYOCARDIAL INFARCTION; A STUDY UTILIZING AN ELECTROCARDIOGRAPHIC MONITOR FOR AUTOMATIC DETECTION AND RECORDING OF ARRHYTHMIAS. N Engl J Med. 1964 Aug 27;271:427–431. doi: 10.1056/NEJM196408272710901. [DOI] [PubMed] [Google Scholar]
  26. Schwartz C. J., Walsh W. J. The pathologic basis of sudden death. Prog Cardiovasc Dis. 1971 Mar;13(5):465–481. doi: 10.1016/0033-0620(71)90012-0. [DOI] [PubMed] [Google Scholar]
  27. Selvester R. H., Haywood L. J. High, gain, high frequency atrial vectorcardiograms in normal subjects and in patients with atrial enlargement. Am J Cardiol. 1969 Jul;24(1):8–17. doi: 10.1016/0002-9149(69)90045-9. [DOI] [PubMed] [Google Scholar]
  28. Spracklen F. H., Besterman E. M., Everest M. S., Litchfield J. W., Petrie M. Late ventricular dysrhythmias after myocardial infarction. Br Med J. 1968 Nov 9;4(5627):364–366. doi: 10.1136/bmj.4.5627.364. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Stock E., Goble A., Sloman G. Assessment of arrhythmias in myocardial infarction. Br Med J. 1967 Jun 17;2(5554):719–723. doi: 10.1136/bmj.2.5554.719. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES