title: Incidence and timing of recurrences of sudden death and ventricular tachycardia during antiarrhythmic drug treatment after myocardial infarction.
abstract: Incidence and timing of recurrences of sustained ventricular tachycardia (VT) or sudden death were studied in 206 patients who survived their first episode of ventricular fibrillation (VF; n = 52) or sustained VT (n = 154) after myocardial infarction. All patients were treated with (empirically selected) antiarrhythmic drugs; 49% received amiodarone. After a mean follow-up of 36 months, 64 patients (41%) in the VT group and 10 (19%) in the VF group had nonfatal VT recurrences. Sudden death occurred in 22 (14%) and 9 (17%) patients in the VT and VF groups, respectively. Incidence of sudden death had 2 peaks at approximately 3 and 12 months. Nonfatal VT recurrences were more frequent (most often occurring in first 6 months) in the VT than in the VF group. Sudden death occurred during the following 3 years in only 10% of patients who survived 1 year. There was a much higher incidence of sudden death in patients with left ventricular ejection fraction (LVEF) less than or equal to 40% than in those with LVEF greater than 40% (28 of 65 vs 3 of 141; p less than 0.0001), but no relation between LVEF and nonfatal VT recurrences.
authors.affiliation: Department of Cardiology, University of Limburg, Academic Hospital, Maastricht, The Netherlans.
authors.forename: L M
authors.initials: LM
authors.lastname: Rodriguez
authors.forename: J
authors.initials: J
authors.lastname: Smeets
authors.forename: G E
authors.initials: GE
authors.lastname: O'Hara
authors.forename: P
authors.initials: P
authors.lastname: Geelen
authors.forename: P
authors.initials: P
authors.lastname: Brugada
authors.forename: H J
authors.initials: HJ
authors.lastname: Wellens
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D012008:Recurrence; D012189:Retrospective Studies; D013610:Tachycardia / Q000188:drug therapy* / Q000209:etiology; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000188:drug therapy / Q000209:etiology
chemical_list: D000889:Anti-Arrhythmia Agents