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Supraventricular arrhythmias after myocardial infarction

Philip J Podrid, MD, FACC
Section Editors
Brian Olshansky, MD
Bernard J Gersh, MB, ChB, DPhil, FRCP, MACC
James Hoekstra, MD
Deputy Editor
Gordon M Saperia, MD, FACC


Supraventricular arrhythmias, other than atrial fibrillation or flutter, are relatively uncommon in the periinfarction period. Their occurrence often indicates myocardial dysfunction and they may, by themselves, cause congestive heart failure or exacerbate ongoing myocardial ischemia.

The incidence, mechanism, and treatment of supraventricular arrhythmias (particularly sinus bradycardia, sinus tachycardia, and atrial fibrillation) occurring after myocardial infarction (MI) will be reviewed here. The following related topics are discussed separately: conduction disturbances after MI, pathophysiology of ventricular arrhythmias during MI, the clinical characteristics and treatment of ventricular arrhythmias with MI, and risk stratification of patients after MI.


Sinus bradycardia, defined as less than 50 to 60 beats/min, occurs in 15 to 25 percent of patients after acute MI [1-3]. It has the following clinical characteristics [1,2,4]:

It is frequently seen with inferior wall infarctions, since the right coronary artery supplies the sinoatrial node (SA) in approximately 60 percent of people.

It is most often transient, particularly for sinus bradycardia occurring within the first six hours; such arrhythmias typically resolve within 24 hours.


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Literature review current through: Sep 2016. | This topic last updated: Mar 25, 2015.
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