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Management of arrhythmias during transportation in patients with acute myocardial infarction.

One of the most important goals in early care of patients with acute myocardial infarction (MI) is providing effective treatment promptly. The GISSI study shows that the reduction in mortality is as high as 50% when patients are treated within the first hour of MI, hence the "golden hour". Many serious arrhythmias develop before hospitalization, even before the patient is monitored. At least 75% of patients with MI have an arrhythmia during the peri-infarct period. Inasmuch as two-thirds of deaths after acute infarction occur before the patient reaches a hospital, therefore it is very important to initiate effective treatment as early as possible after the onset of symptoms. Early reperfusion to salvage myocardium has a beneficial effect on in-hospital and late prognosis. But, some serious arrhythmias requiring treatment are also seen commonly following successful reperfusion. As a conclusion, it seems necessary for every community to establish a strategy to reach patients with suspected MI and transfer them rapidly to the nearest health care facility. If there is a delay during transportation, the ambulance team should be ready to administer thrombolytics and treat the arrhythmia, which might occur. In this review the treatment of arrhythmia, which may occur during transportation will be discussed.