Cardiac Arrhythmias in Thai Acute Coronary Syndrome Registry
Tachapong Ngarmukos MD, FACC*, Charn Sriratanasthavorn MD, FACC**, Buncha Sansaneevithayakul MD***, Piya Kasemsuwan MD****, Kitiporn Angkasuwapala MD*****, Sukit Yamwong MD*
Affiliation : * Ramathibodi Hospital, Mahidol University, Bangkok ** Siriraj Hospital, Mahidol University, Bangkok *** King Chulalongkorn Memorial University Hospital, Chulalongkorn University, Bangkok **** Vajira Hospital, Bangkok ***** Rajavithi Hospital, Bangkok
Background : The incidence of arrhythmic complications in Thai patients with acute coronary syndromes
(ACS) has not been previously reported. The present study results will serve as the local database for future
studies.
Objective : To evaluate the incidence of arrhythmic complications in ASC in Thai patients and to identify
factors that may affect arrhythmia complications in ACS patients.
Materials and Methods : Data collected from 9,373 patients from the Thai acute coronary syndrome registry
(TACSR) were analyzed. This registry includes patients who presented with ACS including ST elevation
myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina
(UA), within 14 days from the symptoms onset.
Results : 395 (4.2%) patients with an ACS presented after cardiac arrest. These patients were noted to have
significantly higher in-hospital mortality (50.1%). The incidence of serious cardiac arrhythmia complica-
tions in the TACSR was 16.6%. Among them, 62.7% were sustained VT/VF, 31.5% had second or third degree
AV block, and 5.8% has both VT/VF and AV Block. The incidence of VT was higher in the younger age group,
while AV block and arrhythmic death were higher in the older aged patients. Arrhythmias complicating ACS
were associated with increased mortality risk. Congestive heart failure (CHF) within the first 48 hours,
current use of tobacco and cardiac troponin elevation were associated with significantly higher arrhythmic
complications during hospitalization.
Conclusion : Arrhythmias complicating ACS were associated with higher in hospital mortality. CHF within
the first 48 hr., current tobacco use and cardiac troponin elevation were associated with significantly higher
arrhythmic complications.
Keywords : Acute coronary syndrome, Cardiac arrhythmia, Ventricular tachycardia, AV block
