Programmed ventricular stimulation reinitiated ventricular tachyarrhythmias in 76% (16 of 21) of myocardial infarction survivors when restudied at a mean of 8 months.
Cohort (n=21)
Are provokable ventricular arrhythmias reproducible long-term in survivors of myocardial infarction?
Provokable ventricular arrhythmias after myocardial infarction are highly reproducible at 8 months, though clinical arrhythmic events during 17-month follow-up were rare in this small cohort.
The long-term reproducibility and significance of inducible ventricular arrhythmias were assessed in 21 survivors of a myocardial infarction. Programmed ventricular stimulation performed a mean of 12 +/- 2 days (range 8 to 18) after infarction provoked ventricular fibrillation in 2 patients, sustained monomorphic ventricular tachycardia in 8 and nonsustained ventricular tachycardia in 11. Patients were restudied using the same protocol a mean of 8 +/- 2 months (range 4 to 11) after infarction. All patients underwent programmed ventricular stimulation studies in the absence of antiarrhythmic drug treatment. Ventricular tachyarrhythmias could be reinitiated in 16 patients (76%): ventricular fibrillation in 2, sustained ventricular tachycardia in 5 (monomorphic in 4) and nonsustained ventricular tachycardia in 9. A preponderance of inferior infarction was observed among patients with reinducible tachycardias (9 of 16 patients versus 0 of 5 with noninducible tachycardias) (p less than 0.05). No significant difference existed between patients with and without reinducible arrhythmias with respect to severity of coronary artery disease, degree of left ventricular dysfunction, occurrence of ventricular fibrillation in the acute phase of infarction and ventricular arrhythmias detected by 24 hour ambulatory electrocardiographic (Holter) monitoring. There was no significant difference between patients with and without a positive late study in stimulation thresholds, ventricular refractory periods, time interval between initial and repeat testing and use of beta-adrenergic blocking agents. During a mean follow-up period of 17 months (range 10 to 23) one patient with inducible sustained monomorphic ventricular tachycardia at both studies died suddenly. The remaining patients have survived follow-up without experiencing an arrhythmic event.(ABSTRACT TRUNCATED AT 250 WORDS)
Roy et al. (Tue,) conducted a cohort in Myocardial infarction (n=21). Programmed ventricular stimulation vs. Initial stimulation study was evaluated on Reinitiation of ventricular tachyarrhythmias at late study. Programmed ventricular stimulation reinitiated ventricular tachyarrhythmias in 76% (16 of 21) of myocardial infarction survivors when restudied at a mean of 8 months.
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