[Idioventricular rhythm in patients with acute myocardial infarction: an indicator of perfusion or ischemic symptom]

Episodes of idioventricular rhythm occur frequently during the first hours of myocardial infarction. In patients receiving thrombolytic therapy, idioventricular rhythms may be an indicator of successful reperfusion--called "reperfusion arrhythmia". The aim of our study was to assess an incidence of idioventricular rhythm and other ventricular arrhythmias and their relations to thrombolytic therapy and reperfusion in a relatively large group of patients with acute myocardial infarction (AMI). The study included 100 patients with AMI, divided into three groups: with anterior, inferior and inferior with right ventricle infarction. Sixty six patients were treated with thrombolysis. 24-hour Holter recordings were obtained in every patient and reperfusion was assessed clinically. Episodes of idioventricular rhythm and other ventricular arrhythmias were more frequent in the thrombolytic group but not in patients with clinically established reperfusion. The main conclusion from our study is, that accelerated idioventricular rhythm is not specific for reperfusion but rather for myocardial ischaemia. The higher incidence of the ventricular arrhythmias in the thrombolytic group partially depends of their earlier hospitalization, and time-dependent inclusion into treated group.