18. Arrhythmias Due to Myocardial Infarction
Published Online: 1 NOV 2012
Copyright © 2013 John Wiley & Sons, Ltd.
Bennett's Cardiac Arrhythmias: Practical Notes on Interpretation and Treatment, Eighth Edition
How to Cite
Bennett, D. H. (2013) Arrhythmias Due to Myocardial Infarction, in Bennett's Cardiac Arrhythmias: Practical Notes on Interpretation and Treatment, Eighth Edition, John Wiley & Sons, Ltd, Oxford. doi: 10.1002/9781118432389.ch18
- Published Online: 1 NOV 2012
- Published Print: 14 JAN 2013
Print ISBN: 9780470674932
Online ISBN: 9781118432389
- Accelerated idioventricular rhythm;
- Atrioventricular (AV) block;
- Myocardial infarction;
- Reperfusion arrhythmias;
- Sinus and junctional bradycardias;
- Supraventricular tachycardias;
- Ventricular arrhythmias;
- Ventricular fibrillation;
- Ventricular tachycardia
Ventricular fibrillation occurs during the first hour of acute myocardial infarction in more than 10% of patients, necessitating immediate defibrillation. Frequent and ‘R on T’ ventricular ectopic beats, and other ‘warning arrhythmias’ are common in acute infarction and are not in fact predictive of ventricular fibrillation. Ventricular fibrillation or tachycardia during the first 24 hours of infarction is unlikely to recur. Atrial fibrillation and ventricular arrhythmias arising 24 hours or more after acute infarction are usually associated with extensive myocardial damage.
Sinus and junctional bradycardia, and complete atrioventricular (AV) block due to inferior infarction, do not require treatment unless causing symptoms or marked hypotension. AV block due to acute inferior infarction will resolve and is not an indication for permanent pacemaker implantation. Bilateral bundle branch damage or high-degree AV block caused by anterior infarction imply extensive myocardial damage and a poor prognosis.