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The management of arrhythmias following an acute myocardial infarction


Arrhythmias are extremely common early after AMI. An arrhythmiasis defined by exclusion, either because the sequence of myocardial depolarisation is other than normal or because certain arbitrary limits are exceeded. It follows that the term “arrhythmia” encompasses a complex heterogeneous group. Although arrhythmias are defined in electrical terms they are only important because of their immediate, delayed or potential haemodynamic consequences. These occur because of changes in heart rate, loss of atrial transport function, increased myocardial oxygen consumption, decreased myocardial blood flow or loos of synchronicity of ventricular contraction. The sensible and effective management of arrhythmias following acute myocardial infarction requires an appraisal of the haemodynamic consequences, if any, which follow the initiation of the arrhythmia. The indications for treating an arrhythmia must be the immediate, delayed or potential haemodynamic loss rather than the mere preseence of a rhythm which falls outside the limits of normal. This distinction is perhaps most clearly seen in the case of atrio-ventricular conduction disturbances.

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Rowlands, D.J. The management of arrhythmias following an acute myocardial infarction. Intensive Care Med 4, 13–19 (1978).

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Key words

  • Acute myocardial infarction
  • Arrhythmias
  • Management