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Ventricular arrhythmias in acute myocardial ischemia : Risk factors, mechanisms, and prognostic value

Demidova, Marina M LU ; Azarov, Jan E and Platonov, Pyotr G LU (2026) In Heart Rhythm
Abstract

Malignant ventricular arrhythmias (VAs) are a major contributor to mortality in myocardial infarction. Although early revascularization has markedly reduced the incidence of late and secondary VA, the occurrence and fatality rates of VA during the prehospital stage remain high. In ST-segment elevation myocardial infarction, most VAs occur within the first 24 hours, with only a small proportion observed during the second day. The risk of early ischemic VA is associated with a short time from symptom onset, potassium imbalance, complete coronary artery occlusion, large ischemic area, and new-onset atrial fibrillation. Some patients exhibit a persistent susceptibility to VA during acute ischemia, which may remain clinically relevant after... (More)

Malignant ventricular arrhythmias (VAs) are a major contributor to mortality in myocardial infarction. Although early revascularization has markedly reduced the incidence of late and secondary VA, the occurrence and fatality rates of VA during the prehospital stage remain high. In ST-segment elevation myocardial infarction, most VAs occur within the first 24 hours, with only a small proportion observed during the second day. The risk of early ischemic VA is associated with a short time from symptom onset, potassium imbalance, complete coronary artery occlusion, large ischemic area, and new-onset atrial fibrillation. Some patients exhibit a persistent susceptibility to VA during acute ischemia, which may remain clinically relevant after discharge and manifest as recurrent VA during subsequent acute coronary events, possibly reflecting an underlying genetic predisposition. Ventricular fibrillation may be predicted by electrocardiographic markers of depolarization delay, repolarization dispersion, and action potential prolongation, with their diagnostic value depending critically on timing during ischemia.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
in press
subject
in
Heart Rhythm
publisher
Elsevier
external identifiers
  • pmid:42019795
ISSN
1547-5271
DOI
10.1016/j.hrthm.2026.04.027
language
English
LU publication?
yes
additional info
Copyright © 2026 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
id
0402cd45-aa9d-41de-8afc-718643078a62
date added to LUP
2026-08-25 09:34:04
date last changed
2026-08-25 11:11:54
@article{0402cd45-aa9d-41de-8afc-718643078a62,
  abstract     = {{<p>Malignant ventricular arrhythmias (VAs) are a major contributor to mortality in myocardial infarction. Although early revascularization has markedly reduced the incidence of late and secondary VA, the occurrence and fatality rates of VA during the prehospital stage remain high. In ST-segment elevation myocardial infarction, most VAs occur within the first 24 hours, with only a small proportion observed during the second day. The risk of early ischemic VA is associated with a short time from symptom onset, potassium imbalance, complete coronary artery occlusion, large ischemic area, and new-onset atrial fibrillation. Some patients exhibit a persistent susceptibility to VA during acute ischemia, which may remain clinically relevant after discharge and manifest as recurrent VA during subsequent acute coronary events, possibly reflecting an underlying genetic predisposition. Ventricular fibrillation may be predicted by electrocardiographic markers of depolarization delay, repolarization dispersion, and action potential prolongation, with their diagnostic value depending critically on timing during ischemia.</p>}},
  author       = {{Demidova, Marina M and Azarov, Jan E and Platonov, Pyotr G}},
  issn         = {{1547-5271}},
  language     = {{eng}},
  month        = {{04}},
  publisher    = {{Elsevier}},
  series       = {{Heart Rhythm}},
  title        = {{Ventricular arrhythmias in acute myocardial ischemia : Risk factors, mechanisms, and prognostic value}},
  url          = {{http://dx.doi.org/10.1016/j.hrthm.2026.04.027}},
  doi          = {{10.1016/j.hrthm.2026.04.027}},
  year         = {{2026}},
}