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Irregular Heartbeat During Angioplasty Could Raise Death Risk
Date:5/5/2009

he rates of mortality are similar."

The finding could challenge current cardiac care guidelines. That's because current rules for implanting a defibrillator -- a device that can deliver a shock to correct an abnormal heartbeat -- say that the implant should not be done in the first 30 days after angioplasty/stenting, Mehta said.

However, it's still premature to say that the guideline should be changed, he noted.

"We don't have enough data to say that," Mehta said. "We may be able to challenge the current guidelines in the future if the data holds up, but currently we don't."

Most cardiologists now believe that episodes of abnormal heart rhythm during PCI are not important, he added. The new findings could change that attitude, singling out people who are at higher risk and require closer monitoring, he said.

About 6 percent (329) of the people in the study experienced arrhythmias; 25 before PCI, 180 during and 117 afterward. The 90-day death rate in those that experienced an irregular heartbeat was just over 23 percent, compared to 3.6 percent for those with no heart rhythm abnormalities. The overall threefold increase in risk was calculated by including other risk factors.

The next step is to determine whether specific interventions might improve the outlook in cases where arrhythmias occur, Mehta said. "We are now doing a longer follow-up of another trial, studying one-year mortality to see if any treatments have improved outcomes," he said.

It is already well known that beta blockers can cut the risk for people with heartbeat abnormalities, Mehta said. "Whether other anti-arrhythmics help, we can't say from the current study," he added.

The study is useful because it may help physicians single out people who need the most attention, said study co-author Dr. Judith S. Hochman, a professor of cardiology at New York University, New York City.

"Its helpful to understand
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