J Cardiovasc Interv.  2024 Apr;3(2):43-51. 10.54912/jci.2023.0021.

Management of Acute Myocardial Infarction Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

• Kim HK
• Kim SS

• KMID: 2560959
• DOI: http://doi.org/10.54912/jci.2023.0021

Abstract

Sudden cardiac death (SCD) in the setting of acute myocardial infarction (AMI) often results from ventricular arrhythmias (VAs) like ventricular tachycardia (VT) or ventricular fibrillation. This can indicate ongoing ischemia, scar tissue development, increased sympathetic tone, or electrolyte imbalances. Prompt revascularization and treatment are crucial, as inhospital mortality can exceed 20%. Risk varies, with reduced ejection fraction (EF) being a key factor. Prevention involves interventions like implantable cardioverter-defibrillators (ICDs) implantation, recommended over drug therapy after 48 hours of AMI if the cause is irreversible. Primary preventive ICD in ischemic cardiomyopathy with reduced EF after 6 weeks is a life-saving measure, and catheter ablation is emerging as a therapeutic option for well-tolerated VT in select post-AMI patients. This review discusses current therapeutic strategies for managing AMI patients with VA and preventing SCD.

Keyword

Arrhythmias; Myocardial infarction; Death