title: Influence of thrombolysis on signal-averaged electrocardiogram and late arrhythmic events after acute myocardial infarction.
abstract: The influence of intravenous thrombolysis on both prevalence of ventricular late potentials and incidence of late arrhythmic events was evaluated in 174 consecutive patients surviving a first acute myocardial infarction; 106 patients (61%) received thrombolysis (group A) and 68 (34%) had conventional therapy (group B). In group A, 18 patients (17%) had late potentials compared with 23 (34%) in group B (p less than 0.05); mean left ventricular ejection fraction was not different (0.50 +/- 0.09 vs 0.50 +/- 0.10; p = not significant [NS]). Of 63 patients who underwent coronary arteriography because of postinfarction ischemia, 28 (44%) had a closed infarct-related artery; of these, 11 (39%) had late potentials compared with 3 of 35 (9%) with a patent artery (p less than 0.01). Mean left ventricular ejection fraction was not significantly different between the 2 groups (0.49 +/- 0.09 vs 0.53 +/- 0.09; p = NS). At a mean follow-up of 14 +/- 8 months, 8 of 161 patients (5%) had a late arrhythmic event; 6 of 8 (75%) with and 28 of 153 (18%) without events had late potentials (p less than 0.001). In group A, 4 of 99 patients (4%) had events compared with 4 of 62 (6%) in group B (p = NS, relative risk 1.6). Of 24 patients with anterior wall AMI and left ventricular dyskinesia, 6 events occurred. In this group of patients, a higher rate of events was observed (25%); 3 of 16 (19%) treated with thrombolysis had an event compared with 3 of 8 (37%) treated conventionally (p = NS, relative risk 2.6).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Divisione di Cardiologia, Centro Medico di Tradate, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Pedretti
authors.forename: A
authors.initials: A
authors.lastname: Laporta
authors.forename: M D
authors.initials: MD
authors.lastname: Etro
authors.forename: A
authors.initials: A
authors.lastname: Gementi
authors.forename: R
authors.initials: R
authors.lastname: Bonelli
authors.forename: C
authors.initials: C
authors.lastname: Anzà
authors.forename: E
authors.initials: E
authors.lastname: Colombo
authors.forename: F
authors.initials: F
authors.lastname: Maslowsky
authors.forename: F
authors.initials: F
authors.lastname: Santoro
authors.forename: B
authors.initials: B
authors.lastname: Carù
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000517:prevention & control*; D016009:Chi-Square Distribution; D004562:Electrocardiography / Q000187:drug effects* / Q000379:methods; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology*; D012815:Signal Processing, Computer-Assisted; D015912:Thrombolytic Therapy