Electrocardiographic Signs of Atrial Infarction and Development of Supraventricular Arrhythmias in Patients with Acute Myocardial Infarction

The relationship between the electrocardiographic signs of atrial infarction and supraventricular arrhythmias was evaluated retrospectively in 214 patiens admitted to Hacettepe University Hospital between January 1, 1992 and December 31, 1992, with (7.5 %) patients had major, and 9 (4.2 %) patients had minor criteria of atrial infarction. Supraventricular arrhythmias, usually atrial fibrillation, were present in 8 of 16 (50 %) patients with major criteria, and 3 of 9 (33 %) patients with minor criteria, giving significantly different odds ratios of 10.0 and 3.9, respectively. Left-sided cardiac failure was detected in 14 of the 26 (54 %) patients with supraventricular arrhythmias. Overall, fifty-five (26 %) patients had left-sided cardiac failure and 14 of them (25 %) had supraventricular arrhythmia during the hospitalization period. There was no significant difference between patients with and without electrocardiographic signs of atrial infarction regarding the myocardial wall involved, the serum levels of cardiac enzymes and mortality. In conclusion, supraventricular arrhythmias may develop in patients who present with PR segment changes in their initial electrocardiograms and those in whom left-sided cardiac failure ensues. Therefore, it may be useful to treat left-sided cardiac failure or in order to prevent its development to prevent the hemodynamic compromise which may be caused by supraventricular arrhythmias.