[Arrhythmia in acute myocardial infarct]

The authors present a review of optimal treatment and prevention of dysrhythmias in the acute stage of myocardial infarction (AIM). They emphasize the necessity to shorten the pre-hospitalization stage of the disease (the prevalence of malignant dysrhythmias culminates) and elaborate in every hospital region an optimal plan of emergency care (ensure CPR, electrical defibrillation, pharmacological prevention of VT and VF). They draw attention to the fundamental importance of the therapeutic limitation ensuing from the size of the focus which implies at the same time prevention and treatment of an impaired cardiac rhythm. The authors recommend early recanalization treatment with subsequent anti-thrombocytic treatment, and if contraindications are absent, standard administration of beta blockers in the early stage of AIM. They draw attention to the asset of anti-arrhythmic treatment as well as to its undesirable effects. They discuss also indications and complications of temporary transvenous cardiac pacing.