 Arrhythmia due to reperfusion after thrombolytic therapy in patients with acute myocardial infarction

Abstract

Objective: The aim of this study was to determine therelation between the incidence and frequency ofventricular arrhytmias and the time course of ST-segment changes in patients with successfulthrombolysis.Method: This study included 46 patients (31 males53±12 years) with acute myocardial infarction (MI) whowere treated with streptokinase (SK Group) and 41 MIpatients (27 males 55±12 years) who did not receiveany thrombolytic agent (Control Group).Electrocardiograms were obtained 90 minutes 6, 12,18, 24, 48 and 72 hours after thrombolytic therapy andreduction in ST elevation at 90 minutes was calculated.All patients had wall motion abnormalities.Results: Overall arrhythmias were observed in 67% (n:31) of patients in SK group compared to 63% (n:26) incontrol group (p=0.05). In subgroup analysis of SKgroup ventricular tachycardia (VT) was more frequent(37%) in patients with more than 50% reduction in STelevation at 90 minutes compared with in othersubgroups of patients (p<0.01). Postinfarction anginaand systolic dysfunction were more frequent in thecontrol group compared to the SK group (p<0.05).Conclusion: Our results suggest that reperfusion withfibrinolytics or the faster reflow may induce ventriculararrhythmias. However, it can also prevent theimpairment in systolic function of the left ventricle.Key words: Myocardial infarction, thrombolysis,reperfusion, arrhythmia