Accelerated idioventricular rhythm occurrence post coronary revascularization in STEMI and association with reperfusion indices.

Aim- The prognostic impact of intra-procedural accelerated idioventricular rhythm (IAIR) occurrence post-contemporary on-time coronary reperfusion for ST elevation myocardial infarction (STEMI) is ill defined. The incidence, timing, and association of IAIR with reperfusion indices in this scenario remains unclarified.

Methods- We retrospectively investigated 198 consecutive patients undergoing primary on-time PCI for a first acute myocardial infarction (AMI). The incidence and timing of IAIR was determined by reviewing the full disclosure ECG recording during the procedure. We tested for possible association between IAIR occurrence and specification and multiple reperfusion indices.
results- IAIR appeared in 17 patients (9%). Patients with IAIR displayed heightened risk factor profile including older age. They exhibited lower mean maximal troponin levels (1660 vs. 2031, P=0.54), higher percentage of marginally affected left ventricular function (76% vs. 66%, P=0.04) and lower occurrence of < 3 final TIMI flow (12% vs. 17%, P=0.12). Moreover, log-rank analysis proved the 30-day mortality to be significantly lower in the group with IAIR, 0% vs. 3.3%, p=0.001.

Conclusion- IAIR has a robust interaction with successful reperfusion indices. IAIR might serve as a better proxy of good outcomes compared with other reperfusion markers.