title: Prognostic significance of ventricular arrhythmias post-myocardial infarction.
abstract: Despite improvements in management strategies, ventricular arrhythmias remain important markers of electrical instability and contribute to the identification of patients at increased risk of sudden cardiac death post-myocardial infarction (MI). Over the past 20 years, understanding of pathophysiological mechanisms and implications of various types of ventricular arrhythmias has evolved remarkably. This systematic review details the prognostic significance of ventricular arrhythmias classified by type and time of onset post-MI. Subacute and late premature ventricular complexes are associated with increased mortality independent of left ventricular function. Although nonsustained ventricular tachycardia (VT) in the acute phase post-MI is of questionable significance, later onset heralds poorer prognosis. Sustained monomorphic VT in the acute post-MI phase is associated with infarct extension, heart failure and increased mortality. Extensive wall motion abnormalities, left ventricular dysfunction and aneurysm formation correlate with later postinfarct sustained VT. Inhospital mortality is higher when ventricular fibrillation presents in the acute phase but long term prognosis is not adversely affected.
authors: Department of Medicine, Montreal Heart Institute, University of Montreal, Montreal, Quebec, Canada. pkhairy@cardio.tch.harvard.edu
authors: Paul
authors: P
authors: Khairy
authors: Bernard
authors: B
authors: Thibault
authors: Mario
authors: M
authors: Talajic
authors: Marc
authors: M
authors: Dubuc
authors: Denis
authors: D
authors: Roy
authors: Peter G
authors: PG
authors: Guerra
authors: Stanley
authors: S
authors: Nattel
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004562:Electrocardiography; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications* / Q000188:drug therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D017180:Tachycardia, Ventricular / Q000145:classification* / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology
chemical_list: D000889:Anti-Arrhythmia Agents