title: Predicting survival with reperfusion arrhythmias during primary percutaneous coronary intervention for acute myocardial infarction.
abstract: BACKGROUND
  The significance of arrhythmia occurring after successful recanalization of an occluded artery during treatment following primary percutaneous coronary intervention for ST-segment elevation myocardial infarction is controversial.
  
  
  OBJECTIVE
  To study the association of reperfusion arrhythmia with short and long-term survival.
  
  
  METHODS
  We used a prospective registry of consecutive STEMI patients undergoing PPCI. Patients with an impaired epicardial flow (TIMI flow grade < 3) at the end of the procedure were excluded.
  
  
  RESULTS
  Of the 688 patients in the study group, 22% were women. Mean (+/- SD) age of the cohort was 61 (+/- 14) years and frequent co-morbidities included diabetes mellitus (25%), dyslipidemia (55%), hypertension (43%) and smoking (41%). RA was recorded in 200 patients (29%). Patients with RA had lower rates of diabetes (16% vs. 30%, P < 0.01) and hypertension (48% vs. 62%, P < 0.01), and a shorter median pain-to-balloon time (201 vs. 234 minutes, P < 0.01) than patients without RA. Thirty day mortality was 3.7% and 8.3% for patients with and without RA, respectively (P = 0.04). After controlling for age, gender and pain-to-balloon time the hazard ratio for mortality for patients with RA during a median follow-up period of 466 days was 0.46 (95% confidence interval 0.23-0.92).
  
  
  CONCLUSIONS
  The occurrence of RA immediately following PPCI for acute STEMI is associated with better clinical characteristics and identifies a subgroup with a particularly favorable prognosis.
authors.affiliation: Department of Cardiology, Soroka University Hospital and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel. iliar@bgu.ac.il
authors.forename: Reuben
authors.initials: R
authors.lastname: Ilia
authors.forename: Doron
authors.initials: D
authors.lastname: Zahger
authors.forename: Carlos
authors.initials: C
authors.lastname: Cafri
authors.forename: Akram
authors.initials: A
authors.lastname: Abu-Ful
authors.forename: Jean Marc
authors.initials: JM
authors.lastname: Weinstein
authors.forename: Sergey
authors.initials: S
authors.lastname: Yaroslavtsev
authors.forename: Harel
authors.initials: H
authors.lastname: Gilutz
authors.forename: Guy
authors.initials: G
authors.lastname: Amit
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000401:mortality; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000401:mortality*; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality* / Q000628:therapy; D015425:Myocardial Reperfusion / Q000009:adverse effects / Q000401:mortality*; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome