title: Arrhythmias in patients with acute coronary syndrome in the first 24 hours of hospitalization.
abstract: OBJECTIVE
  In patients with acute coronary syndrome (ACS), we sought to: 1) describe arrhythmias during hospitalization, 2) explore the association between arrhythmias and patient outcomes, and 3) explore predictors of the occurrence of arrhythmias.
  
  
  METHODS
  In a prospective sub-study of the IMMEDIATE AIM study, we analyzed electrocardiographic (ECG) data from 278 patients with ACS. On emergency department admission, a Holter recorder was attached for continuous 12-lead ECG monitoring.
  
  
  RESULTS
  Approximately 22% of patients had more than 50 premature ventricular contractions (PVCs) per hour. Non-sustained ventricular tachycardia (VT) occurred in 15% of patients. Very few patients (≤ 1%) had a malignant arrhythmia (sustained VT, asystole, torsade de pointes, or ventricular fibrillation). Only more than 50 PVCs/hour independently predicted an increased length of stay (p < .0001). No arrhythmias predicted mortality. Age greater than 65 years and a final diagnosis of acute myocardial infarction independently predicted more than 50 PVCs per hour (p = .0004).
  
  
  CONCLUSIONS
  Patients with ACS seem to have fewer serious arrhythmias today, which may have implications for the appropriate use of continuous ECG monitoring.
authors: Fairfield University School of Nursing, Fairfield, CT, USA.
authors: Catherine
authors: C
authors: Winkler
authors: Marjorie
authors: M
authors: Funk
authors: Daniel M
authors: DM
authors: Schindler
authors: Jessica Zegre
authors: JZ
authors: Hemsey
authors: Rachel
authors: R
authors: Lampert
authors: Barbara J
authors: BJ
authors: Drew
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications*; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000209:etiology*; D015716:Electrocardiography, Ambulatory; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Acute coronary syndrome; Acute myocardial infarction; Alarms; Arrhythmia; Electrocardiogram; Outcomes
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