 Arrhythmia due to reperfusion after thrombolytic therapy in patients with acute myocardial infarction

Abstract

Objective: The aim of this study was to determine the
relation between the incidence and frequency of
ventricular arrhytmias and the time course of ST-segment changes in patients with successful
thrombolysis.
Method: This study included 46 patients (31 males
53±12 years) with acute myocardial infarction (MI) who
were treated with streptokinase (SK Group) and 41 MI
patients (27 males 55±12 years) who did not receive
any thrombolytic agent (Control Group).
Electrocardiograms were obtained 90 minutes 6, 12,
18, 24, 48 and 72 hours after thrombolytic therapy and
reduction in ST elevation at 90 minutes was calculated.
All patients had wall motion abnormalities.
Results: Overall arrhythmias were observed in 67% (n:
31) of  patients in SK group compared to 63% (n:26) in
control group (p=0.05). In subgroup analysis of SK
group ventricular tachycardia (VT) was more frequent
(37%) in patients with more than 50% reduction in ST
elevation at 90 minutes compared with in other
subgroups of patients (p<0.01). Postinfarction angina
and systolic dysfunction were more frequent in the
control group compared to the SK group (p<0.05).
Conclusion: Our results suggest that reperfusion with
fibrinolytics or the faster reflow may induce ventricular
arrhythmias. However, it can also prevent  the
impairment in systolic function of the left ventricle.
Key words: Myocardial infarction, thrombolysis,
reperfusion,  arrhythmia

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