A COMPARATIVE ANALYSIS OF FREQUENCY OF IN-HOSPITAL ARRHYTHMIAS IN PATIENTS WITH SUCCESSFUL VERSUS FAILED THROMBOLYSIS FOLLOWING ACUTE MYOCARDIAL INFARCTION

Abstract

Objective: To compare frequency of in-hospital arrhythmias in patients withsuccessful and failed thrombolysis using streptokinase in patients presentingwith acute myocardial infarction (AMI).

Methodology: This was a comparative study conducted at department ofCardiology, Lady Reading Hospital,Peshawar from October 2006 to October2007 .Two hundred patients with first AMI were divided into two groups: group A(successful thrombolysis) and group B (failed thrombolysis) using ECG criteria.

Results: A total of 200 patients were studied. Group A included 136 (68%)patients while group B included 64 (32%) patients. Among these 24 (12.0 %)patients developed arrhythmias. Of these 8 patients were in group A and 16patients were in group B (5.9% vs. 25.0%, p=0.003).Ventricular tachycardiawas the most common arrhythmia. It was documented in 9 (4.5%) patients, with2 patients in group A and 7 patients in group B (1.5% vs. 10.9%, p=0.003). Theother arrhythmias which included atrial fibrillation, ventricular fibrillation andsupraventricular tachycardia were statistically insignificant between the twogroups (p=0.174). In hospital mortality was more common in patients withfailed thrombolysis [6 (9.4%) vs. 3 (2.2%) (p=0.023)].

Conclusion: Failed thrombolysis is associated with complex arrhythmias andhigh in- hospital mortality.