[Management of ventricular tachycardia after acute myocardial infarct].

Manazment komorovej tachykardie po akútnom infarkte myokardu.

Publisher: AEP Press Country of Publication: Slovakia NLM ID: 0065324 Publication Model: Print Cited Medium: Print ISSN: 0006-9248 (Print) Linking ISSN: 00069248 NLM ISO Abbreviation: Bratisl Lek Listy Subsets: MEDLINE

Publication: <2001->: Bratislava, Slovakia : AEP Press
Original Publication: Bratislava : SAP-Slovak Academic Press s.r.o.

Myocardial Infarction/*complications ; Tachycardia, Ventricular/*diagnosis; Adult ; Aged ; Death, Sudden, Cardiac ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Tachycardia, Ventricular/drug therapy ; Tachycardia, Ventricular/etiology

Background: Risk stratification of malignant ventricular tachyarrhythmias and sudden cardiac death after myocardial infarction is essentially important for high risk patients identification, who require specific therapeutic procedures. Non-invasive risk markers--LVEF, late potentials LP, Q-T dispersion, decreased heart rate variability (HRV) and baroreflex sensitivity (BRS)--and ventricular tachycardia inducibility have low positive predictive value. The appropriate combination and consecutiveness which will provide most precise identification of patients threatened by sudden arrhythmic death, applicable to all patients after myocardial infarction, is being analysed.
Methods: In a group of 87 patients after myocardial infarction suffering from ventricular tachycardia retrospective assessment of sudden cardiac death risk markers incidence was performed.
Results: 1. The most frequent risk marker was LVEF 0.40 (48.3%), abnormal LP (84.9%), DQT 80 ms and decreased HRV (73.1%) and their combinations. 2. Patients with inducible ventricular tachycardia (62.1%) had lower LVEF in comparison with non-inducible ventricular tachycardia patients (0.42 +/- 0.11 vs 0.51 +/- 0.01, p = 0.002), higher QT dispersion (85.0 +/- 30.5 ms versus 63.6 +/- 30.7 ms, p = 0.003). 3. In patients with recurrent malignant ventricular tachyarrhythmias and sudden cardiac death occurring during the follow-up is sustained inducible ventricular tachycardia with antiarrhythmic therapy and induction of ventricular tachycardia during native state significantly more frequent. LVEF is significantly reduced, FQRS on SAECG is significantly prolonged, DQT is significantly higher.
Conclusion: On the basis of the results and data from literature the authors recommend LVEF assessment in all patients after myocardial infarction and further stratification in patients with left ventricular dysfunction.

Date Created: 20000106 Date Completed: 20000124 Latest Revision: 20161026

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