[Arrhythmia profile and sudden cardiac death in early and late resuscitated patients following myocardial infarct].
The arrhythmia profile has been studied in 40 patients (pts) with acute myocardial infarction (MI) resuscitated early (less than 24 hours post MI, group I) and late (4-12 weeks post MI, group II) using 24 h Holter monitoring (HM) at the time of LV- and coronary angiography (HM A) with an average follow-up of 27 months (7-61) (HM B). Forty pts with an acute MI without resuscitation served as controls (group III). Mortality for sudden cardiac death (scd) (death within 24 hours after beginning of symptoms) was significantly higher in group II (6/14 or 42.9%; 13% per year) than in group I (4/26 or 15.4%; 5.9% per year) (p less than 0.05) or in group III (3/40 or 7.5%; 1.8% per year) (p less than 0.001). In HM A there were no significant differences with regard to PVCs and complex arrhythmias using qualitative and quantitative analysis in groups I-III as well as between survivors and scd-pts. In HM B survivors in group II had significantly more PVCs (mean = 1347), couplets (mean = 29) and salvos (mean = 11) than in group I (PVC, mean = 355; couplets, mean = 3; salvos, mean = 0.1; p less than 0.05) or in group III (PVC, mean = 455; couplets, mean = 4; salvos, mean = 0.8; p less than 0.05). They also showed significantly more PVCs (mean = 1480), couplets (mean = 35) and salvos (mean = 15) than in HM A (PVC, mean = 1347; couplets, mean = 3; salvos, mean = 0; p less than 0.05). There were no significant differences between HM A and HM B in groups I and III. It can be concluded that the risk of sudden cardiac death was increased in pts resuscitated 4-12 weeks post MI in comparison to pts with early resuscitation or without resuscitation post MI. In these high risk pts repeated studies using Holter monitoring were helpful in estimating the further risk of sudden cardiac death.
D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis*; D006328:Cardiac Catheterization; D005117:Cardiac Complexes, Premature / Q000175:diagnosis; D017023:Coronary Angiography; D003645:Death, Sudden / Q000209:etiology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009203:Myocardial Infarction / Q000150:complications* / Q000628:therapy; D011379:Prognosis; D012151:Resuscitation; D012306:Risk; D014693:Ventricular Fibrillation / Q000175:diagnosis
Arrhythmieprofil und plötzlicher Herztod bei früh und spät nach Infarkt reanimierten Patienten.