What is the incidence of cardiac arrhythmias in patients with acute myocardial infarction (MI, heart attack), and what treatment is indicated?

Updated: May 07, 2019
  • Author: A Maziar Zafari, MD, PhD, FACC, FAHA; Chief Editor: Eric H Yang, MD  more...
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Cardiac arrhythmias are not uncommon during and immediately after an acute MI. The incidence increases with ST-elevation MI STEMI and decreases with non-STEMI (NSTEMI). Of all patients who have an acute MI, about 90% develop some form of cardiac arrhythmias. In 25% of patients, such rhythm abnormalities occur within the first 24 hours. The risk of serious arrhythmias, such as ventricular fibrillation (VF), is greatest in the first hour and then declines thereafter. 

Most peri-infarction arrhythmias are benign and self-limited. However, aggressively monitor and treat arrhythmias that result in hypotension, increase myocardial oxygen requirements, and/or predispose the patient to malignant ventricular arrhythmias.

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