comparative analysis of frequency of in-hospital arrhythmias in patients with successful versus failed thrombolysis following acute myocardial infarction

ABSTRACT

To compare frequency of in-hospital arrhythmias in patients with successful and failed thrombolysis using streptokinase in patients presenting with acute myocardial infarction [AMI]. This was a comparative study conducted at department of Cardiology, Lady Reading Hospital,Peshawar from October 2006 to October 2007 .Two hundred patients with first AMI were divided into two groups group A [successful thrombolysis] and group B [failed thrombolysis] using ECG criteria. A total of 200 patients were studied. Group A included 136 [68%] patients while group B included 64 [32%] patients. Among these 24 [12.0%] patients developed arrhythmias. Of these 8 patients were in group A and 16 patients were in group B [5.9% vs. 25.0%, p=0.003].Ventricular tachycardia was the most common arrhythmia. It was documented in 9 [4.5%] patients, with 2 patients in group A and 7 patients in group B [1.5% vs. 10.9%, p=0.003]. The other arrhythmias which included atrial fibrillation, ventricular fibrillation and supraventricular tachycardia were statistically insignificant between the two groups [p=0.174]. In hospital mortality was more common in patients with failed thrombolysis [6 [9.4%] vs. 3 [2.2%] [p=0.023]]. Failed thrombolysis is associated with complex arrhythmias and high in- hospital mortality