[Changes in the cardiac rhythm in ischemic cardiopathy]

Ventricular arrhythmia associated with ischemic heart disease has an important role in the etiology of sudden death, both in acute and chronic coronary syndromes. The etiopathogenesis of ventricular arrhythmia is strictly linked to the time-course from the occurrence of coronary occlusion. In the very acute phase of the ischemia, ventricular arrhythmias are due to a reentry mechanism, while 4-8 hours after occlusion the enhanced automatism, and triggered activity are the key mechanisms. Therefore reentry mechanisms are the main factors responsible for postinfarction arrhythmias. Also autonomic mechanisms, electrolytes and pharmacological therapy may contribute to cause arrhythmias.