Prognostic value of non-sustained ventricular tachycardias after acute myocardial infarction in the thrombolytic era: importance of combination with frequent ventricular premature beats.
OBJECTIVE
of this study was to re-evaluate the association between ventricular arrhythmias and long-term mortality after acute myocardial infarction (AMI) in the thrombolytic era.


METHODS
MITRA (maximal individual therapy in patients with AMI) is a multicenter registry of 54 hospitals in Germany investigating patients with AMI.


RESULTS
2420 patients received Holter ECG. Positive Holter ECG was defined: > or =10 ventricular premature beats (VPB)/h, or > or =4 couplets/d, or > or =1 non-sustained ventricular tachycardia (nsusVT)/d, or their combination. Mortality rates (median 17 months) were 6.5% without ventricular arrhythmias, with > or =10 VPB/h 15.2% and with the combination of > or =10 VPB/h plus either > or =4 couplets/d or > or =1 nsusVT/d 23.4%. In multivariate analysis, none of the ventricular arrhythmias alone correlated with mortality. There was a significant association between mortality and the combination of > or =10 VPB/h plus > or =4 couplets/d (OR 2.3) or > or =10 VPB/h plus > or =1 nsusVT/d (OR 2.8).


CONCLUSIONS
Non-sustained VTs are only associated with poor prognosis if combined with frequent VPBs.
Drögemüller
A
A
Herzzentrum Ludwigshafen, Kardiologie, Bremserstr. 79 67063 Ludwigshafen, Germany. Droegema@klilu.de
Seidl
K
K
Schiele
R
R
Schneider
S
S
Gitt
A
A
Gottwik
M
M
von Leitner
E R
ER
Poppe
C
C
Rettig-Stürmer
G
G
Senges
J
J
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002423:Cause of Death; D004359:Drug Therapy, Combination; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D015428:Myocardial Reperfusion Injury / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D015996:Survival Rate; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D015912:Thrombolytic Therapy; D016896:Treatment Outcome; D018879:Ventricular Premature Complexes / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D001241:Aspirin