How long should high-risk patients with acute anterior wall myocardial infarction be monitored?
In 143 patients with an acute anterior wall myocardial infarction, left ventricular ejection fraction was determined within 72 h of admission. Left ventricular ejection fraction was below 40% in 114 patients. In this group late ventricular tachycardia or ventricular fibrillation occurred in 30 patients (26%). A left ventricular ejection fraction below 40% identified all patients who developed any late ventricular tachycardia and a left ventricular ejection fraction below 30% identified all who developed late ventricular fibrillation. After discharge another 2 patients with late ventricular tachycardia were detected. Death between 48 h and 3 weeks only occurred in patients with a left ventricular ejection fraction below 30%. Thus in patients with an acute anterior wall myocardial infarction a left ventricular ejection fraction below 30% within the first 72 h after the acute event identifies a high risk for late ventricular tachycardia or ventricular fibrillation. The occurrence of late ventricular tachycardia showed a gradual increase during 3 weeks of monitoring and no cut-off point could be detected within this time-window.
Bouwels
L
L
Department of Cardiology, Canisius-Wilhelmina Hospital, Nijmegen, Netherlands.
Hertzberger
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002037:Bundle-Branch Block / Q000175:diagnosis; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction; D011446:Prospective Studies; D012307:Risk Factors; D013318:Stroke Volume; D013610:Tachycardia / Q000175:diagnosis; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000175:diagnosis