Arrhythmias in Acute Coronary Syndrome: Mechanisms, Management, and the Influence of Comorbidities

Abstract Background: Acute coronary syndrome (ACS) remains a major cause of mortality and morbidity worldwide. Despite advances in reperfusion and pharmacologic therapy, cardiac arrhythmias continue to be frequent and clinically significant complications. The coexistence of arterial hypertension, metabolic syndrome, and other cardiometabolic risk factors further exacerbates myocardial ischemic injury and electrical instability. Objective: To summarize and compare contemporary evidence and expert consensus regarding the mechanisms, incidence, monitoring, and management of cardiac rhythm disorders in ACS, as presented in key position papers, clinical reviews, and evidence-based guidelines.