Arrhythmias in the Coronary Care Unit Recognized with the Aid of Automated ECG Monitoring

Publisher Website
Google Scholar
Abstract
Arrhythmia incidence in 339 patients with and 340 without proven acute myocardial infarction (AMI) has been compared with the aid of an automated arrhythmia monitoring system. Seventeen diagnoses of arrhythmia could be made with the system and resulted in alarms. All ECG write‐outs were analysed manually. The patients were further divided into subclasses of previous myocardial infarction, other previous or present heart diseases (HD), and no previous HD. Except for atrial fibrillation or flutter and bradycardia, all arrhythmias studied were significantly more common in patients with than without AMI. Arrhythmia incidences in AMI/non‐AMI patients regarding paired ventricular ectopic beats (VBs), tachycardia (heart rate >120/min), paroxysmal supraventricular tachycardia (SVT), and more than 5 VBs per min were 72/38, 55/34, 50/22 and 49/29%, respectively. Arrhythmia incidence in the various subclasses of AMI patients did not differ markedly. In the non‐AMI group, most ventricular arrhythmias were less common in patients without HD. The mortality in asystole, ventricular fibrillation and ventricular tachycardia (VT) did not differ between AMI and non‐AMI patients. Most other ventricular and supraventricular arrhythmias were associated with a poorer prognosis in AMI than in non‐AMI patients. No statistical difference in outcome was observed between AMI patients with and without VT. In AMI, paired VBs or SVT carried a good prognosis during stay in the Coronary Care Unit (CCU). The prognostic implications of several arrhythmias and, possibly, the indications for antiarrhythmic treatment in the CCU will be changed with improved monitoring methods.