Distribution characteristics of reperfusion arrhythmias and the relationship between reperfusion arrhythmias and autonomic nervous imbalance in patients with acute myocardial infarction

AIM:To observe the distribution characteristics of reperfusion arrhythmias and evaluate the relationship between the autonomic nerve imbalance and reperfusion arrhythmias in patients with acute ST-segment elevation myocardial infarction (STEMI) during direct percutaneous coronary intervention (PCI). METHODS: All patients had PCI within 12 h after AMI. Those patients whose infarct-related artery was totally occluded were selected and divided into three groups (LAD group, LCX group and RCA group) according to infarction-related arteries. The autonomic nerve imbalance were evaluated by heart rate and blood pressure. RESULTS: The incidence of RA was 44% in all patients with AMI. RA occurred more often in patients with RCA infarction than other patients with LAD infarction or LCX infarction (65% vs. 35% and 33%, P<0.01). RA occurred more often in patients with early reperfusion. Sympathetic overactivty often occurred in patients with LAD infarction. Vagal overactivity occurred often in patients with RCA infarction. There were significant differences between the two groups. CONCLUSION: The total incidence rate of RA after reperfusion with direct PCI was 44% in all patients with acute ST-segment elevation myocardial infarction. The incidence of RA in patients with RCA infarction was higher than in other patients. The earlier the reperfusion by PCI, the higher the incidence rate of RA. Reperfusion arrhythmia was associated with autonomic nervous imbalance in patients with AMI.