[The clinico-electrocardiographic prodromes of fatal cardiac arrhythmias in patients with an acute myocardial infarct]

Abstract

The authors made a retrospective analysis of case histories of 201 patients who had died of fatal cardiac arrhythmias. The predictors of their death were ventricular fibrillation in 133 (66.2%) patients, asystole in 68 (32.8%), electromechanical dissociation in 2 (1%). Terminal sinus tachycardia, atrial fibrillation and flutter, the second-third degree atrioventricular block, the third-fifth grade ventricular extrasystole were the most common clinical and electrocardiographic prodromes of ventricular fibrillation. In the development of the latter, various mixed disturbances of cardiac rhythm and conduction in combination with prolonged Q-T interval were of more unfavorable value. Asystole was more frequently preceded by the second-third degree atrioventricular block, complete bundle branch block, third-fifth grade ventricular extrasystole, atrial fibrillation and flutter, and various mixed disturbances of cardiac rhythm and conduction. Cardiac arrhythmias and conduction disturbance with prolonged Q-T interval were found to be precursors of asystole in 84.8%.