Why the study?
Do ventricular arrhythmia (VA) bursts during the reperfusion phase indicate larger infarct size in STEMI patients?
Do ventricular arrhythmia (VA) bursts during the reperfusion phase indicate larger infarct size in STEMI patients?
Ventricular arrhythmia bursts during reperfusion in STEMI patients indicate a larger infarct size, even when optimal epicardial and microvascular reperfusion is achieved.
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VA burst monitoring should not yet guide STEMI care; leaves open its value for infarct size prognostication beyond imaging.
OBJECTIVE: We hypothesized that ventricular arrhythmia (VA) bursts during reperfusion phase are a marker of larger infarct size despite optimal epicardial and microvascular perfusion. METHODS: 126 STEMI patients were studied with 24h continuous, 12-lead Holter monitoring. Myocardial blush grade (MBG) was determined and VA bursts were identified against subject-specific background VA rates in core laboratories. Delayed-enhancement cardiovascular magnetic resonance imaging was used to determine infarct size. RESULTS: In the group with MBG 3 no significant differences were found for baseline characteristics between burst versus no burst (102 vs. 24). In those with optimal epicardial and microvascular reperfusion (TIMI 3, stable ST-recovery, and MBG 3), VA burst was associated with larger infarct size (N=102/126; median 11.0 vs. 5.1%; p=0.004). CONCLUSION: In the event of MBG 3, VA bursts were associated with significantly larger infarct size even if optimal epicardial and microvascular reperfusion was present.
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Weg et al. (2016) studied this question.
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