Value of programmed stimulation and exercise testing in predicting one-year mortality after acute myocardial infarction.
The ability of programmed ventricular stimulation and exercise testing to predict 1-year mortality after acute myocardial infarction (AMI) was investigated in 228 clinically well survivors of AMI. Patients with inducible ventricular tachycardia (VT) or ventricular fibrillation (VF) had a higher mortality rate than those without inducible arrhythmias (26% vs 6%, p less than 0.001). Exercise-induced ST-segment change of 2 mm or more was associated with a higher mortality rate than ST change of less than 2 mm (11% vs 4%, 0.05 less p less than 0.10). Of patients who had both tests, 62% had no inducible ventricular tachycardia or ventricular fibrillation and ST change of less than 2 mm, and only 1% died during the first year. Thus, in clinically well survivors of AMI, programmed stimulation is a powerful predictor of first-year mortality; programmed stimulation and exercise testing together predict virtually all deaths within the first year, and they can identify a large group of patients with a very low mortality rate.
D000328:Adult; D000368:Aged; D001315:Australia; D002304:Cardiac Pacing, Artificial; D017023:Coronary Angiography; D004558:Electric Stimulation; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality* / Q000503:physiopathology; D010349:Patient Compliance; D011379:Prognosis; D013610:Tachycardia / Q000503:physiopathology; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000503:physiopathology