[Occurrence of abnormal late ventricular potentials in myocardial ischemia and the determination of risk of sudden cardiac death in patients after myocardial infarct].
BACKGROUND
The crucial step in prevention of sudden cardiac death (SCD) is a method of a precise and most accessible identification of those patients with ischaemic cardiac disease (ICD), especially after MI, who are highly presumptive candidates of malign ventricular arrhythmias. The selection of individuals exposed to risk, and individual judgment of the threat to patients after MI is a complex problem. Patients after MI are endangered by reinfarction, cardiac failure, heart wall rupture and primary ventricular tachyarrhythmia. Stratification of patients exposed to a presumably higher risk of probable new coronary event and malign ventricular arrhythmia with an early decision to intervene, gains practical clinical significance. Similarly, it is important to identify also the patients after MI exposed to lower risk, who need no interventional therapeutical procedure. The cardiologic practice utilizes several examinatory procedures and tests, prevailingly of non-invasive character.


OBJECTIVE
The study reviews the latest information on pathophysiology and current level of clinical interpretation of non-invasive ecg procedure from the field of high-resolution electrocardiography including the late ventricular potentials (LVP). The study is aimed at: a) presentation of a review of available information from the field of electrophysiology and clinical electrocardiography and the mechanism of impact of myocardial ischaemia on the existence of high-frequency, but at the same time extremely low-amplitude potentials abnormalities in the course of QRS complex and S-T segment (LVP), b) presentation of a review on the informative value and clinical significance produced by non-invasively detected electrophysiological heterogeneity of myocardium during ischaemia, aiding the short-term and long-term prognosis judgments in patients with ICD, especially after undergoing its most serious form--myocardial infarction. Beside the group analysis the study is also aimed at individual non-invasive judgment of risk of the development of malign ventricular arrhythmias in patients with acute coronary syndromes. (Fig. 3, Ref. 41.)
Filipová
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IV. interná klinika Lekárskej fakulty Univerzity Komenského Bratislava, Slovakia.
Mikus
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Cagán
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D016757:Death, Sudden, Cardiac / Q000209:etiology* / Q000517:prevention & control; D004562:Electrocardiography; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D012307:Risk Factors
Výskyt abnormálnych neskorých komorových potenciálov pri ischémii myokardu a pri urcovaní rizika náhlej srdcovej smrti u pacientov po infarkte myokardu.