18. Arrhythmias Due to Myocardial Infarction

  1. David H. Bennett MD FRCP

Published Online: 1 NOV 2012

DOI: 10.1002/9781118432389.ch18

Bennett's Cardiac Arrhythmias: Practical Notes on Interpretation and Treatment, Eighth Edition

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

Author Information

  1. Senior Consultant Cardiologist, University Hospital of South Manchester, Manchester, UK

Publication History

  1. Published Online: 1 NOV 2012
  2. Published Print: 14 JAN 2013

ISBN Information

Print ISBN: 9780470674932

Online ISBN: 9781118432389

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Keywords:

  • Accelerated idioventricular rhythm;
  • Arrhythmias;
  • Atrioventricular (AV) block;
  • Myocardial infarction;
  • Reperfusion arrhythmias;
  • Sinus and junctional bradycardias;
  • Supraventricular tachycardias;
  • Ventricular arrhythmias;
  • Ventricular fibrillation;
  • Ventricular tachycardia

Summary

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.