title: [Effect of thrombolytic therapy on occurrence of complex ventricular arrhythmias in the late hospitalization period in acute myocardial infarct: relation with long-term remodeling of the left ventricle].
abstract: BACKGROUND
  The impact of thrombolytic therapy on the incidence of complex ventricular arrhythmias is not yet clarified. The aim of this study was to investigate the impact of thrombolytic therapy on the incidence of complex ventricular arrhythmias, as well as long term association between complex ventricular arrhythmias and left ventricular remodelling, and their impact on five-year lethality.
  
  
  METHODS
  Ninety seven consecutive patients with first acute myocardial infarction (streptokinase was administered in 58 patients), underwent 24-hours Holter monitoring at discharge. Ventricular arrhythmias were classified according to Lown classification, and patients were grouped into the group with simple ventricular arrhythmias (Lown class 0 to 2), and the group with complex ventricular arrhythmias (Lown class 3 to 5). Echocardiography was performed at discharge, and six and twelve months after the infarction. Left ventricular volume indexes and ejection fraction was determined using Simpson's biplane formula.
  
  
  RESULTS
  In patients with complex ventricular arrhythmias left ventricular volume indexes were higher and ejection fraction was lower throughout the study, whereas wall motion score index was higher one year after the infarction. On the other hand, these variables were similar throughout the follow-up within the groups of patients with and without complex ventricular arrhythmias who received thrombolytic therapy. The incidence of complex ventricular arrhythmias was similar in thrombolyzed and non-thrombolyzed patients (11/58 vs. 5/39). There was no difference in five year lethality between patients with and without complex ventricular arrhythmias (4/16 vs. 13/81 patients).
  
  
  CONCLUSIONS
  Our data indicated that left ventricular remodelling in patients with complex ventricular arrhythmias was not progressive after hospital discharge. The presence of complex ventricular arrhythmias was not associated with the increased five-year lethality, despite of more pronounced left ventricular remodelling. It occurred that thrombolysis per se had no influence on the incidence of complex ventricular arrhythmias in the late hospital phase after the first acute myocardial infarction.
authors: Institut za kardiovaskularne bolesti, Dedinje, Centar za kardiovaskularna istrazivanja Dr Aleksandar D. Popović, Beograd.
authors: Petar
authors: P
authors: Otasević
authors: Aleksandar N
authors: AN
authors: Nesković
authors: Zoran
authors: Z
authors: Popović
authors: Alja
authors: A
authors: Vlahović
authors: Milan
authors: M
authors: Vuković
authors: Branislava
authors: B
authors: Borzanović
authors: Aleksandar D
authors: AD
authors: Popović
mesh_terms: D001145:Arrhythmias, Cardiac / Q000139:chemically induced / Q000175:diagnosis / Q000209:etiology*; D004562:Electrocardiography; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D011446:Prospective Studies; D015912:Thrombolytic Therapy / Q000009:adverse effects; D020257:Ventricular Remodeling