OBJECTIVES: In patients with acute coronary syndrome (ACS), we sought to: 1) describe arrhythmias during hospitalization, 2) explore the association between arrhythmias and patient outcomes, and 3) explore predictors of the occurrence of arrhythmias. METHODS: In a prospective sub-study of the IMMEDIATE AIM study, we analyzed electrocardiographic (ECG) data from 278 patients with ACS. On emergency department admission, a Holter recorder was attached for continuous 12-lead ECG monitoring. RESULTS: Approximately 22% of patients had more than 50 premature ventricular contractions (PVCs) per hour. Non-sustained ventricular tachycardia (VT) occurred in 15% of patients. Very few patients (≤ 1%) had a malignant arrhythmia (sustained VT, asystole, torsade de pointes, or ventricular fibrillation). Only more than 50 PVCs/hour independently predicted an increased length of stay (p < .0001). No arrhythmias predicted mortality. Age greater than 65 years and a final diagnosis of acute myocardial infarction independently predicted more than 50 PVCs per hour (p = .0004). CONCLUSIONS: Patients with ACS seem to have fewer serious arrhythmias today, which may have implications for the appropriate use of continuous ECG monitoring.
OBJECTIVES: In patients with acute coronary syndrome (ACS), we sought to: 1) describe arrhythmias during hospitalization, 2) explore the association between arrhythmias and patient outcomes, and 3) explore predictors of the occurrence of arrhythmias. METHODS: In a prospective sub-study of the IMMEDIATE AIM study, we analyzed electrocardiographic (ECG) data from 278 patients with ACS. On emergency department admission, a Holter recorder was attached for continuous 12-lead ECG monitoring. RESULTS: Approximately 22% of patients had more than 50 premature ventricular contractions (PVCs) per hour. Non-sustained ventricular tachycardia (VT) occurred in 15% of patients. Very few patients (≤ 1%) had a malignant arrhythmia (sustained VT, asystole, torsade de pointes, or ventricular fibrillation). Only more than 50 PVCs/hour independently predicted an increased length of stay (p < .0001). No arrhythmias predicted mortality. Age greater than 65 years and a final diagnosis of acute myocardial infarction independently predicted more than 50 PVCs per hour (p = .0004). CONCLUSIONS:Patients with ACS seem to have fewer serious arrhythmias today, which may have implications for the appropriate use of continuous ECG monitoring.
Authors: Sana M Al-Khatib; Amanda L Stebbins; Robert M Califf; Kerry L Lee; Christopher B Granger; Harvey D White; Paul W Armstrong; Eric J Topol; E Magnus Ohman Journal: Am Heart J Date: 2003-03 Impact factor: 4.749
Authors: C Dubois; J P Smeets; J C Demoulin; L Piérard; G Foidart; L Henrard; C Tulippe; L Preston; J Carlier; H E Kulbertus Journal: Eur Heart J Date: 1986-11 Impact factor: 29.983
Authors: A P Maggioni; G Zuanetti; M G Franzosi; F Rovelli; E Santoro; L Staszewsky; L Tavazzi; G Tognoni Journal: Circulation Date: 1993-02 Impact factor: 29.690
Authors: Sean D Pokorney; Christina Radder; Phillip J Schulte; Sana M Al-Khatib; Pierluigi Tricocci; Frans Van de Werf; Stefan K James; Christopher P Cannon; Paul W Armstrong; Harvey D White; Robert M Califf; C Michael Gibson; Robert P Giugliano; Lars Wallentin; Kenneth W Mahaffey; Robert A Harrington; L Kristin Newby; Jonathan P Piccini Journal: Am Heart J Date: 2015-09-12 Impact factor: 4.749