Reduced prognostic power of ventricular late potentials in post-infarction patients of the reperfusion era.
OBJECTIVE
To test the prognostic value of ventricular late potentials (LPs) in a large cohort of post-infarction patients in the modern reperfusion era.


RESULTS
1800 consecutive survivors of acute myocardial infarction in sinus rhythm and under 76 years of age were enrolled. Many (99%) of the patients received reperfusion/revascularization therapy (91% percutaneous coronary intervention) and up-to-date pharmacological treatment (99% aspirin, 93% beta-blockers, 90% ACE-inhibitors, and 85% statins). LPs were calculated in 968 patients and found to be present in 90 (9.3%). The primary endpoint was the composite of cardiac death and serious arrhythmic events. The secondary endpoint was the composite of sudden cardiac death and serious arrhythmic events. During follow-up (median 34 months), 26 patients reached the primary endpoint. The presence of LPs was not significantly associated with the primary endpoint in univariable or multivariable analysis. In contrast, low (< or = 30%) left ventricular ejection fraction (hazard ratio 9.6, 95% confidence interval 4.1-22.4), heart rate turbulence category 2 (7.5, 2.4-23.9) and category 1 (5.3, 1.9-14.9) were significant predictors in both univariable and multivariable analysis.


CONCLUSIONS
Ventricular LPs are of limited use for risk stratification in unselected post-infarction patients in the modern reperfusion era.
Bauer
Axel
A
Medizinische Klinik der Technischen Universität München, Ismaninger Strasse 22, 81675 München, Germany.
Guzik
Przemyslaw
P
Barthel
Petra
P
Schneider
Raphael
R
Ulm
Kurt
K
Watanabe
Mari A
MA
Schmidt
Georg
G
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D016757:Death, Sudden, Cardiac / Q000209:etiology; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000379:methods / Q000401:mortality*; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000401:mortality; D015912:Thrombolytic Therapy / Q000379:methods / Q000401:mortality; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000401:mortality