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Ventricular Arrhythmias During Acute Myocardial Ischemia/Infarction: Mechanisms and Management

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Cardiac Arrhythmias

Abstract

Ventricular arrhythmias during the acute phase of myocardial infarction are common and account for approximately 80 % of sudden cardiac death cases. A biphasic curve has been observed in various species and possibly applies also in man. The incidence of ventricular arrhythmias in the prehospital phase has remained stable during the past decade, but in-hospital rates have declined markedly, mainly due to the widespread use of reperfusion therapies. Ventricular tachycardia and fibrillation are generated by all known arrhythmogenic mechanisms, acting successively or in combination. However, the factors governing the susceptibility to ischemia-related arrhythmias remain incompletely understood. Beta-blockade is the mainstay of treatment; class I agents have been largely superseded by amiodarone, but combined administration may be warranted in difficult cases. The effect of ventricular arrhythmias on long-term prognosis needs to be examined in large-scale studies.

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Abbreviations

APD:

Action potential duration

ATP:

Adenosine triphosphate

ERP:

Effective refractory period

ET:

Endothelin

MI:

Myocardial infarction

VF:

Ventricular fibrillation

VT:

Ventricular tachycardia

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Authors and Affiliations

  1. Department of Cardiology, University of Ioannina, 1 Stavrou Niarxou Avenue, Ioannina, 45110, Greece

    Theofilos M. Kolettis MD, PhD, FESC

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  1. Theofilos M. Kolettis MD, PhD, FESC
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Correspondence to Theofilos M. Kolettis MD, PhD, FESC .

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Editors and Affiliations

  1. Department of Cardiology, Center Hospitalier Coutances, Coutances, France

    Ambrose S. Kibos

  2. Department of Internal Medicine Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

    Bradley P. Knight

  3. Division of Cardiology, McGill University Health Center, Montreal, Québec, Canada

    Vidal Essebag

  4. Department of Cardiology, Miami Children's Hospital, Miami, Florida, USA

    Steven B. Fishberger

  5. School of Biology, Chemistry and Health, Manchester Metropolitan University, Manchester, United Kingdom

    Mark Slevin

  6. “Acad. Vasile Candea” Emergency Clinical Center for Cardiovascular Diseases, “Carol Davila” University of Medicine and Pharmacy, “Titu Maiorescu” University Faculty of Medicine,, Bucharest, Romania

    Ion C. Țintoiu

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Kolettis, T.M. (2014). Ventricular Arrhythmias During Acute Myocardial Ischemia/Infarction: Mechanisms and Management . In: Kibos, A., Knight, B., Essebag, V., Fishberger, S., Slevin, M., Țintoiu, I. (eds) Cardiac Arrhythmias. Springer, London. https://doi.org/10.1007/978-1-4471-5316-0_18

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