Arrhythmias with brief, high-dose intravenous streptokinase infusion in acute myocardial infarction

Cardiac arrhythmias are described during the first 2 h afterbrief, high-dose, intravenous streptokinase infusion in 23 patientswith evolving myocardial infarction was given. A control groupconsisted of 22 similar patients with acute myocardial infarctionnot treated with streptok inase infusion. On the basis of anearly peak of creatine kinase activity successful reperfusionwas achieved in 60.9% of patients. Significantly more ventricularpremature complexes (P<0.01) and paroxysms of idioventricularrhythm (P<0.05) were noticed in the treated group. Prematureventricular complexes did not predict any severe ventriculararrhythmia. Accelerated idioventricular rhythm appears to bethe most specific arrhythmia encountered with thrombolytic therapyof acute myocardial infarction. We propose that in routine clinicalwork it can be used as a bedside sign ofsuccessful reperfusion.