title: Ventricular arrhythmias in patients recovering from myocardial infarction: do residual myocardial ischemia and anti-ischemic medical intervention influence the one-month prevalence? The Danish Study Group on Verapamil in Myocardial Infarction.
abstract: The relationship between myocardial ischemia revealed by exercise testing and ventricular arrhythmias on Holter monitoring, and the effect of anti-ischemic intervention on the incidence of ventricular arrhythmias in patients with residual ischemia were studied in 125 patients recovering from myocardial infarction. Prior to discharge exercise testing and 24-h Holter monitoring were carried out. In patients with ST-segment depression (n = 34), ventricular arrhythmias on Holter monitoring were seen in 7 (21%) compared with 20 (22%) patients without ST-segment depression (NS). Patients were hereafter double-blindly randomized to intervention with verapamil (n = 63) or placebo (n = 62). One month after discharge, 24-h Holter monitoring was repeated. In the verapamil group ventricular arrhythmias increased from 25 to 33% (NS). In the placebo group the figures were 18 and 27%, respectively (NS). In patients with ST-segment depression and verapamil treatment, the prevalence increased from 25 to 38% (NS). In the placebo group the figures were 17 and 22%, respectively (NS). The differences between the groups were not significant. A significantly increased prevalence of ventricular arrhythmias was found in patients with either heart failure or non-Q-wave infarct. In these patients myocardial ischemia during exercise did not correlate with ventricular arrhythmias either. ST-segment depression during pre-discharge exercise testing correlated with neither the prevalence nor the incidence of ventricular arrhythmias, and anti-ischemic intervention with verapamil did not influence the incidence of ventricular arrhythmias in both patients with and without myocardial ischemia.
authors.affiliation: Medical Department 2 and Holter Laboratory, Municipal Hospital, Copenhagen, Denmark.
authors.forename: C M
authors.initials: CM
authors.lastname: Jespersen
authors.forename: M
authors.initials: M
authors.lastname: Vaage-Nilsen
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D004311:Double-Blind Method; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D017202:Myocardial Ischemia / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D015995:Prevalence; D016896:Treatment Outcome; D014700:Verapamil / Q000627:therapeutic use*
chemical_list: D014700:Verapamil