Arrhythmias in patients with acute coronary syndrome in the first 24 hours of hospitalization.
Arrhythmias in patients with acute coronary syndrome in the first 24 hours of hospitalization.
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DOI：
10.1016/j.hrtlng.2013.07.010
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发表时间：
2013-11
期刊：
影响因子：
2.8
通讯作者：
Drew, Barbara J.
中科院分区：
文献类型：
--
作者：
Winkler, Catherine;Funk, Marjorie;Schindler, Daniel M.;Hemsey, Jessica Zegre;Lampert, Rachel;Drew, Barbara J.
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. 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. 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). Patients with ACS seem to have fewer serious arrhythmias today, which may have implications for the appropriate use of continuous ECG monitoring.
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