Arrhythmias with brief, high-dose intravenous streptokinase infusion in acute myocardial infarction.

Cardiac arrhythmias are described during the first 2 h after brief, high-dose, intravenous streptokinase infusion in 23 patients with evolving myocardial infarction was given. A control group consisted of 22 similar patients with acute myocardial infarction not treated with streptokinase infusion. On the basis of an early peak of creatine kinase activity successful reperfusion was achieved in 60.9% of patients. Significantly more ventricular premature complexes (P less than 0.01) and paroxysms of idioventricular rhythm (P less than 0.05) were noticed in the treated group. Premature ventricular complexes did not predict any severe ventricular arrhythmia. Accelerated idioventricular rhythm appears to be the most specific arrhythmia encountered with thrombolytic therapy of acute myocardial infarction. We propose that in routine clinical work it can be used as a bedside sign of successful reperfusion.