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Related Experiment Videos

Reperfusion arrhythmia: myth or reality?

R E Burney1, D Walsh, L R Kaplan

  • 1Division of Emergency Services, University of Michigan, Ann Arbor.

Annals of Emergency Medicine
|March 1, 1989
PubMed
Summary

Reperfusion arrhythmias are not a significant risk during transport for acute myocardial infarction patients receiving thrombolytic therapy. This study found no increased arrhythmia incidence in transferred patients who received thrombolysis.

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Area of Science:

  • Cardiology
  • Emergency Medicine
  • Critical Care

Background:

  • Early experimental studies suggested "reperfusion arrhythmia" could complicate thrombolytic therapy for acute myocardial infarction.
  • Concerns existed that reperfusion-induced arrhythmias might increase risks during patient transfer.

Purpose of the Study:

  • To determine if reperfusion arrhythmia is a clinically significant concern in acute myocardial infarction patients transferred during thrombolytic therapy.
  • To assess the incidence of specific arrhythmias before and during transport in patients receiving thrombolysis.

Main Methods:

  • Retrospective review of hospital and transfer records for 500 acute myocardial infarction patients transferred between 1985 and 1987.
  • Data collected included occurrence of ventricular fibrillation, ventricular tachycardia, premature ventricular contractions, bradycardia, and atrioventricular block.

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  • Patients were categorized based on receipt of thrombolytic therapy and type of myocardial infarction.

    • Main Results:

    • No deaths occurred during transfer, with overall survival through hospitalization at 91%.
    • Arrhythmia incidence decreased from 36% before transport to 12% during transport.
    • No significant difference in arrhythmia occurrence was observed between patients who received thrombolytic therapy and those who did not.

    Conclusions:

    • Reperfusion arrhythmia does not appear to be a clinically significant complication during the transport of acute myocardial infarction patients undergoing intravenous thrombolytic therapy.
    • Transferring patients receiving thrombolysis is safe, with low arrhythmia rates during transit.
    • Current evidence does not support increased transfer risk due to reperfusion arrhythmias in this patient population.