Irregular Heartbeat During Angioplasty Could Raise Death Risk

May 6 -- TUESDAY, May 5 (HealthDay News) -- People treated for heart attack who experience abnormal heart rhythms during artery-opening procedures such as angioplasty may be at increased risk of death, a new study suggests.

The finding could challenge current cardiac care guidelines, experts say.

The study focused on patients who had heartbeat abnormalities called ventricular tachycardia or ventricular fibrillation when they underwent what is formally called a percutaneous coronary intervention (PCI) -- such as angioplasty with or without stent placement -- for heart attack.

Patients who experienced these cardiac arrhythmias during the procedure had about triple the odds of dying within 90 days as those whose hearts beat normally, the researchers found.

"Arrhythmias have a significant impact on longer-term survival," concluded study author Dr. Rajendra H. Mehta, an associate consulting professor of medicine at Duke University in Durham, N.C.

His team published the findings in the May 6 issue of the Journal of the American Medical Association.

The study, which included more than 5,700 people treated at 296 centers in 17 countries, produced results that differed considerably from those of a 2004 study, which Mehta also led. That study found no increased risk of death for people with heart arrhythmias during a PCI.

However, the earlier trial "included only lower-risk patients," Mehta noted. "This [newer] study was designed to look at patients at higher risk."

People with more severe heart attacks and less blood flow to the heart were at higher risk of heart rhythm abnormalities during an angioplasty, the study showed.

Another important finding of the study was that "most deaths occur very early in this population," Mehta said. "Most deaths occur in the first 30 days. Other than that, the 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.