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Answer 7
  1. None of the above. Studies have not demonstrated that the development of ventricular tachyarrhythmias during the first 24 to 48 hours after MI is predictive of an increased risk of future sudden cardiac death. In contrast, ventricular arrhythmias experienced more than 48 hours after MI portend a worse prognosis. Because the patient had no additional arrhythmic episodes, no additional studies are warranted at this time. Defibrillator placement would be indicated if the patient’s ejection fraction continues to be less than 30% or if symptoms of congestive heart failure exist 4 weeks after his MI.4,5

     Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA guidelines for the management of patients with ST- elevation myocardial infarction—executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines on the Management of Patients With Acute Myocardial Infarction) [published erratum appears in J Am Coll Cardiol 2005; 45:1376]. J Am Coll Cardiol 2004;44:671-719.

    5. Zipes DP, Camm AJ, Borggrefe M, et al; European Heart Rhythm Association; Heart Rhythm Society. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death). J Am Coll Cardiol 2006;48:e247-346.

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