[Frequency and type of arrhythmias in patients with chronic coronary disease]

Serious arrhythmias are accepted to be the main cause of sudden death in acute coronary artery disease (CAD). The purpose of this study was to evaluate the frequency and type of cardiac arrhythmias in patients with chronic CAD. 67 patients with suspected chronic CAD, documented by history and/or Ecg-changes, were investigated by means of a dynamic Ecg (Holter Avionics) with an average of 11 hours monitoring. On the basis of concomitant ST-segment depressions the patients were divided into 3 groups (A: greater than 0.1mV; B: 0.05-0.09mV; C: less than 0.05mV). The frequency of serious arrhythmias increased significantly with a greater degree of ST-segment depression. Serious arrhythmias were observed in 54% in group A, in 46% in group B, but only in 24% in group C. The frequency of minor arrhythmias such as occasional (less than 12/min atrial or ventricular premature contractions was essentially the same in all 3 groups. In 12 patients more than one serious arrhythmia were documented. Of the serious arrhythmias observed, 94% were tachycardias and/or secondary to increased myocardial irritability and therefore could respond favourably to beta-blocking agents. We believe that arrhythmias in patients with known chronic CAD should be taken seriously and longterm treatment with beta-blockers considered.