EN | TR
E-ISSN: 2980-261X
Evaluation of the Patients with Post-infarction Ventricular Tachycardia and Programmed Ventricular Stimulation
PDF
Cite
Share
Request
Original Research
VOLUME: 1 ISSUE: 1
P: 1-5
April 2023

Evaluation of the Patients with Post-infarction Ventricular Tachycardia and Programmed Ventricular Stimulation

Bull Crdiov Acad 2023;1(1):1-5
DOI: 10.4274/kvbulten.galenos.2023.98608
Demet Erciyes
1. Demiroğlu Bilim Üniversitesi Tıp Fakültesi, Kardiyoloji Anabilim Dalı, İstanbul, Türkiye
No information available.
No information available
Received Date: 15.03.2023
Accepted Date: 24.04.2023
Publish Date: 14.06.2023
PDF
Cite
Share
Request

ABSTRACT

Objective:

Ventricular rhythm disorders which after myocardial infarction has a negative effect on the prognosis. We studied 49 patients with one or more episodes of ventricular tachycardia (VT) lasting longer than 30 seconds, less than fifteen days after myocardial infarction. In our study we research the factors determining the risk of mortality in the five-year follow-up of these patients.

Material and Methods:

All patients consisted of cases who presented with VT attack after discharge. Programmed ventricular stimulation, late potential examination (LP) and rhythm Holter follow-up were performed to all patients. Holter and LP analyzes were performed at 6-month intervals in the follow-up for 5 years, and PSV was performed in the first 3 months.

Results:

Forty four men and five women, 49 patients who had myocardial infarction constitute the study group. The average age is 55 (between 33 and 79). Seventeen cases died during the study period, 10 of them were due to heart disease. Low left ventricular ejection fraction is one of the determining factors in high mortality. If left ventricular ejection fraction was less than 35% the five-year survival was 67%, and if the left ventricular ejection fraction was greater than 35%, the five-year survival was 80%. Anterior myocardial infarction has a higher mortality rate than inferior myocardial infarction. However, in our study, the difference was not found as significant. In treatment types comparison, treatment with amiodarone or different antiarrhythmic drug or ablation, there was no statistically significant difference neither.

Conclusion:

Due to the small number of patients in our study, we think, further studies with larger patient groups are needed.

References

1Avitall B, McKinnie J, Jazayeri M, Akhtar M, Anderson AJ, Tchou P. Induction of ventricular fibrillation versus monomorphic ventricular tachycardia during programmed stimulation. Role of premature beat conduction delay. Circulation 1992;85(4):1271-1278.
2Bigger JT Jr, Fleiss JL, Kleiger R, Miller JP, Rolnitzky LM. The relationships among ventricular arrhythmias, left ventricular dysfunction, and mortality in the 2 years after myocardial infarction. Circulation 1984;69(2):250-258.
3de Vreede JJ, Gorgels AP, Verstraaten GM, Vermeer F, Dassen WR, Wellens HJ. Did prognosis after acute myocardial infarction change during the past 30 years? A meta-analysis. J Am Coll Cardiol 1991;18(3):698-706.
4Denniss AR, Richards DA, Cody DV, Russell PA, Young AA, Cooper MJ, et al. Prognostic significance of ventricular tachycardia and fibrillation induced at programmed stimulation and delayed potentials detected on the signal-averaged electrocardiograms of survivors of acute myocardial infarction. Circulation 1986;74(4):731-745.
5Gomes JA, Winters SL, Martinson M, Machac J, Stewart D, Targonski A. The prognostic significance of quantitative signal-averaged variables relative to clinical variables, site of myocardial infarction, ejection fraction and ventricular premature beats: a prospective study. J Am Coll Cardiol 1989;13(2):377-384.
6Gomes JA, Winters SL, Stewart D, Horowitz S, Milner M, Barreca P. A new noninvasive index to predict sustained ventricular tachycardia and sudden death in the first year after myocardial infarction: based on signal-averaged electrocardiogram, radionuclide ejection fraction and Holter monitoring. J Am Coll Cardiol 1987;10(2):349-357.
7Breithardt G, Cain ME, el-Sherif N, Flowers NC, Hombach V, Janse M, et al. Standards for analysis of ventricular late potentials using high-resolution or signal-averaged electrocardiography. A statement by a Task Force Committee of the European Society of Cardiology, the American Heart Association, and the American College of Cardiology. Circulation 1991;83(4):1481-1488.
8Mason JW. A comparison of electrophysiologic testing with Holter monitoring to predict antiarrhythmic-drug efficacy for ventricular tachyarrhythmias. Electrophysiologic Study versus Electrocardiographic Monitoring Investigators. N Engl J Med 1993;329(7):445-451.
9Waller TJ, Kay HR, Spielman SR, Kutalek SP, Greenspan AM, Horowitz LN. Reduction in sudden death and total mortality by antiarrhythmic therapy evaluated by electrophysiologic drug testing: criteria of efficacy in patients with sustained ventricular tachyarrhythmia. J Am Coll Cardiol 1987;10(1):83-89.
10Herre JM, Sauve MJ, Malone P, Griffin JC, Helmy I, Langberg JJ, et al. Long-term results of amiodarone therapy in patients with recurrent sustained ventricular tachycardia or ventricular fibrillation. J Am Coll Cardiol 1989;13(2):442-449.
11Rae AP, Greenspan AM, Spielman SR, Sokoloff NM, Webb CR, Kay HR, et al. Antiarrhythmic drug efficacy for ventricular tachyarrhythmias associated with coronary artery disease as assessed by electrophysiologic studies. Am J Cardiol 1985;55(13 Pt 1):1494-1499.
12Chadda K, Goldstein S, Byington R, Curb JD. Effect of propranolol after acute myocardial infarction in patients with congestive heart failure. Circulation 1986;73(3):503-510.
13Determinants of predicted efficacy of antiarrhythmic drugs in the electrophysiologic study versus electrocardiographic monitoring trial. The ESVEM Investigators. Circulation 1993;87(2):323-329.
14Hurwitz JL, Josephson ME. Sudden cardiac death in patients with chronic coronary heart disease. Circulation 1992;85(1 Suppl):I43-149.
15Willems AR, Tijssen JG, van Capelle FJ, Kingma JH, Hauer RN, Vermeulen FE, et al. Determinants of prognosis in symptomatic ventricular tachycardia or ventricular fibrillation late after myocardial infarction. The Dutch Ventricular Tachycardia Study Group of the Interuniversity Cardiology Institute of The Netherlands. J Am Coll Cardiol 1990;16(3):521-530.
16Peter CT, Helfant RH. Postinfarction ventricular tachycardia and fibrillation: reassessing the role of drug therapy and approach to the high risk patient. J Am Coll Cardiol 1990;16(3):531-532.
17Rodriguez LM, Oyarzun R, Smeets J, Brachmann J, Schmitt C, Brugada P, et al. Identification of patients at high risk for recurrence of sustained ventricular tachycardia after healing of acute myocardial infarction. Am J Cardiol 1992;69(5):462-464.
18Brugada P, Talajic M, Smeets J, Mulleneers R, Wellens HJ. The value of the clinical history to assess prognosis of patients with ventricular tachycardia or ventricular fibrillation after myocardial infarction. Eur Heart J 1989;10(8):747-752.
19Greenspon AJ. Programmed electrical stimulation of the heart in patients with ventricular tachyarrhythmias. Cardiovasc Clin 1992;22(1):71-93.
Article is only available in PDF format. Show PDF
2024 ©️ Galenos Publishing House