Abstract
Objective: To compare frequency of in-hospital arrhythmias in patients with successful and failed thrombolysis using streptokinase in patients presenting with acute myocardial infarction (AMI).
Methodology: This was a comparative study conducted at department of Cardiology, Lady Reading Hospital, Peshawar from October 2006 to October 2007. Two hundred patients with first AMI were divided into two groups: group A (successful thrombolysis) and group B (failed thrombolysis) using ECG criteria.
Results: A total of 200 patients were studied. Group A included 136 (68%) patients while group B included 64 (32%) patients. Among these 24 (12.0 %) patients developed arrhythmias. Of these 8 patients were in group A and 16 patients were in group B (5.9% vs. 25.0%, p=0.003). Ventricular tachycardia was the most common arrhythmia. It was documented in 9 (4.5%) patients, with 2 patients in group A and 7 patients in group B (1.5% vs. 10.9%, p=0.003). The other arrhythmias which included atrial fibrillation, ventricular fibrillation and supraventricular tachycardia were statistically insignificant between the two groups (p=0.174). In hospital mortality was more common in patients with failed thrombolysis [6 (9.4%) vs. 3 (2.2%) (p=0.023)].
Conclusion: Failed thrombolysis is associated with complex arrhythmias and high in- hospital mortality.