European Journal of Cardiovascular Medicine

Introduction: Acute MI is one of leading causes of death and majority of deaths are due to arrhythmias. The aim of this study was to evaluate the incidence and risk factors and outcomes of fatal arrhythmias. Early revascularization reduces the risk of fatal arrhythmias.  Most arrhythmias causes deaths within 48 hours and it includes bradyarrhythmias, heart blocks, atrial fibrillation and ventricular tachycardia and fibrillation. Aims and objectives: This study examines arrhythmias in acute coronary syndrome patients in the first 24 hours following presentation. Method: We collected hospital data from June 2022 to june 2023 with a 3 months follow-up after discharge. The study assessed clinical presentation, ECG monitoring of 900 ACS patients. Data was rigorously collected, including demographics, clinical information, and follow-up outcomes. Inclusion criteria: includes adults over 18 years with Acute MI. Exclusion criteria:  contraindications for monitoring, severe arrhythmias, communication issues. Result: Patients with acute myocardial infarction (AMI) were 2.21 times more likely to have >50 PVCs per hour. Those over 65 had a 2.41 times higher risk. The model fit well (chi-square value 14.79, p = 0.0004). Length of stay strongly correlated with AMI diagnosis (F value 35.41, p < 0.0001). Various arrhythmias were found, including PVCs (44.44%), non-sustained VT (20.44%), supraventricular (11.33%), and atrial fibrillation (6.55%). Sustained VT (2.44%), asystole (2.22%), torsade de pointes (1.11%), and ventricular fibrillation (1.11%) were less common but serious. Right bundle branch block was the most frequent conduction deficit (5.77%), followed by 2nd degree (2.66%) AV block, left anterior fascicular block (2.88%), left bundle branch block (1.77%), and left posterior fascicular block (0.88%). These findings emphasize the range of arrhythmias and conduction issues, highlighting the need for tailored therapeutic and monitoring approaches. Conclusion: This study concluded that life-threatening arrhythmias were less common compared to benign ventricular ectopics and supraventricular tachycardia in ACS patients in PCI era. Patient had favourable outcome if they received timely PCI.Isolated PVCs affected approximately 25% of the sample. It independently increased hospital stay but did not affect other outcomes.