[Clinical features and treatment of ventricular tachycardia associated with acute myocardial infarction].
Three hundred and ninety-two consecutive patients with acute myocardial infarction (AMI) were studied to delineate the clinical features of ventricular tachycardia (VT) (three or more VPC). The incidence of VT in AMI was 23.5% and was higher in inferior AMI (29.8%) than in anterior AMI (19.3%) (p less than 0.05). The incidence of ventricular fibrillation (VF) and mortality were higher in the VT group than in the non-VT group. VT was most frequent on the first day after the onset of AMI. However, another peak of the occurrence of VT was observed in the 4th week after AMI in the anterior AMI group, but not in the inferior AMI group. The late-onset VT had a rapid heart rate during the VT attack (209 +/- 42 vs 170 +/- 62 beats/min, p less than 0.05) which frequently developed to VF (20.9 vs 8.4%, p less than 0.05). This was associated with severe heart failure and indicated a poor prognosis (mortality; 75.0 vs 24.2%, p less than 0.01), when compared with VT that occurred in the early period after the onset of AMI. The effectiveness of the thump-version for the termination of VT was 60.9%. Lidocaine was effective at 57.1%.
First Department of Internal Medicine, Nippon Medical School.
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Nejima
D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D004554:Electric Countershock; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000473:pathology; D011379:Prognosis; D013610:Tachycardia / Q000209:etiology / Q000628:therapy*
D008012:Lidocaine