Cor Vasa 2021, 63(5):541-546 | DOI: 10.33678/cor.2021.035

(Assessing the presence of clinically significant arrhythmias in post-myocardial infarction patients with left ventricular ejection fraction of 36-50%)

Vít Gloger^{a, b}, Miloš Táborský^b

^a Kardiologické oddělení, Krajská nemocnice T. Bati, a.s., Zlín

^b I. interní kardiologická klinika, Lékařská fakulta Univerzity Palackého a Fakultní nemocnice Olomouc, Olomouc

Background: Studies focused on arrhytmias in post-myocardial infarction patients provide us with data mainly about patients with heart failure with reduced ejection fraction. Arrhythmias in post-myocardial infarction patients with heart failure with mid-range ejection fraction have not been studied in detail yet.

Methods: Two groups of post-myocardial infarction patients with ejection fraction 36-50% were monitored, Group 1 with implantable ECG loop recorders and Group 2 with 24-hour ECG Holter monitoring performed every 6 months. The primary outcome measure was the presence of clinically significant arrhythmias. The secondary composite outcome measure were hospital readmissions for heart failure, acute myocardial infarction, stroke, cardiovascular and all-cause deaths.

Results: A total of 41 patients were included in the study (15 in Group 1, 26 in Group 2). The mean ages were 67.1±10.9 and 63.8±11.6 years (p = 0.37), respectively. Clinically significant arrhythmias were noted in seven Group 1 patients (46.7%) and one (4%) Group 2 patient (p < 0.001). The secondary composite outcome was observed in three cases (20%) in Group 1 and two cases (8%) in Group 2 (p = 0.26).

Keywords: Atrial fibrillation, Bradycardia, Heart failure with mid-range ejection fraction, Myocardial infarction, Ventricular tachycardia, Conclusion: The study results show that following myocardial infarction, clinically significant arrhythmias may also develop in patients LVEF of 36-50%. Of course, the highest yield is obtained by continuous monitor- ing with an implantable ECG loop recorder. However, the limitations may be the invasiveness of its implantation and the costs. A compromise may be to identify patients most at risk in whom the ECG loop recorder would be implanted. For that, results from large randomized studies are needed.

Received: February 10, 2021; Revised: February 10, 2021; Accepted: March 14, 2021; Published: October 20, 2021  Show citation