Published online Mar 26, 2023. doi: 10.4330/wjc.v15.i3.106
Peer-review started: December 12, 2022
First decision: January 20, 2023
Revised: January 24, 2023
Accepted: February 22, 2023
Article in press: February 22, 2023
Published online: March 26, 2023
Processing time: 98 Days and 9.4 Hours
ST-elevation myocardial infarction (STEMI) increases QT dispersion (QTD) and corrected QT dispersion (QTcD), and is also associated with ventricular arrhythmia. Fibrinolytic therapy or primary percutaneous coronary intervention (PPCI) was used as the reperfusion strategy in acute STEMI patients.
Cardiac arrhythmia in the setting of acute myocardial infarction (MI) has serious impact on patient morbidity and mortality. Every effort should be made to prevent post-MI arrhythmia and to predict its occurrence as early as possible.
To compare the impact of revascularization with fibrinolysis or PPCI in STEMI patients on cardiac electrical stability, as indicated by QTD and QTcD measurements.
Two groups of patients were treated for acute STEMI; 1 group of patients were treated with fibrinolysis, and the other group of patients were treated with PPCI. QTD and QTcD were measured at baseline and at 24 hr following successful reperfusion. We compared these measures between the two groups and observed all patients for incidence of arrhythmia during hospital admission.
There were significant reductions in QTD and QTcD at 24 hr in both study groups. QTD and QTcD were found to be shorter in group I at 24 hr than in group II. Moreover, the incidence of in-hospital arrhythmia was significantly higher in group II as compared to group I.
In STEMI patients, both PPCI and fibrinolytic therapy effectively reduced QTD and QTcD, with a more significant reduction observed after PPCI. Furthermore, PPCI was associated with a lower incidence of in-hospital arrhythmia.
PPCI was superior to fibrinolytic therapy with respect to the electrical stability of the heart.