Abstract 2028: Right Ventricular Infarction is Associated with a High Rate of Atrial Fibrillation and Ventricular Arrhythmias in Patients with Inferior ST-Elevation Myocardial Infarction
Background: The incidence of arrhythmic complications after inferior ST-elevation myocardial infarction (STEMI) and right ventricular (RV) myocardial infarction (MI) in comparison to anterior MI remains unclear.
Methods: Clinical features and outcomes, including new-onset atrial fibrillation (AF), ventricular tachycardia or fibrillation (VT/VF), and second or third degree heart block, were analyzed in 154,579 pts with anterior and inferior STEMI with and without RV MI using the National Registry of Myocardial Infarction (NRMI). All STEMI pts eligible for reperfusion therapy in NRMI 3, 4 and 5 admitted from April 1998-December 2006, were studied. The following groups were compared:
Inferior MI without RV MI
Inferior MI with RV MI but without shock
Inferior MI with RV MI and shock
Anterior MI without shock, and
Anterior MI with shock.
Results:. Inferior MI with RV MI and shock had the highest incidence of new onset AF (24.8%) while inferior MI alone had the lowest rate of 7.2%. Anterior and inferior MI with RV MI and shock had the highest incidence of VT/VF (38.3% and 34.0%, p=0.32). RV MI without shock had a higher incidence of new onset AF and VT/VF than anterior MI without shock. The incidence of 2nd or 3rd degree heart block was approximately 2% in all groups except in patients with inferior MI with RV MI and shock (0.7%).
Conclusions: Right ventricular infarction, with and without shock, is associated with an increased incidence of new onset AF and ventricular tachycardia and fibrillation.