Relation between ventricular arrhythmia and sudden cardiac death in patients with acute myocardial infarction: the predictors of ventricular fibrillation.
Continuous electrocardiographic monitoring was recorded in 102 patients during the first 48 hours after the onset of myocardial infarction. One hundred forty-eight episodes of ventricular tachycardia having an ectopic rate of 180/min or more and without a background of treatment with antiarrhythmic drugs were analyzed; these included 125 cases of ventricular tachycardia that terminated spontaneously and 23 cases that deteriorated to ventricular fibrillation. Episodes of ventricular tachycardia with a polymorphic configuration were more frequent in the group with than in the group without ventricular fibrillation (30.4 and 8%, respectively). The incidence of ventricular tachycardia continuing for more than 100 QRS complexes was 20 times greater in the group with ventricular fibrillation, and ventricular tachycardia initiated by and R on T ventricular premature beat was recorded three times more often in this group. The 10 minute pretachycardia interval in both groups showed no significant difference in the incidence, complexity, intensity or dynamic pattern of ventricular premature contractions. The data provide reason to doubt the significance of ventricular premature beats as harbingers of sudden death from ventricular fibrillation. Rather, ventricular tachycardia with an ectopic rate of 180/min or more, a polymorphic configuration and persistence for more than 100 QRS complexes (or initiated by an R on T ventricular premature beat) is a more reliable predictor of the occurrence of ventricular fibrillation.
J
J
Bluzhas
D
D
Lukshiene
B
B
Shlapikiene
J
J
Ragaishis
D000328:Adult; D000368:Aged; D005117:Cardiac Complexes, Premature / Q000150:complications; D003645:Death, Sudden / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D013610:Tachycardia / Q000150:complications*; D014693:Ventricular Fibrillation / Q000150:complications*