The electrocardiographic reperfusion peak in patients with ST-elevation myocardial infarction.
OBJECTIVE
To analyse the incidence and the prognostic value of the reperfusion peak in a population of patients with AMI treated with thrombolysis.


METHODS
Two hundred and sixty-nine patients with ST-elevation myocardial infarction treated with thrombolysis were monitored with continuous on-line vectorcardiography.


RESULTS
A reperfusion peak defined as a transiently increased ST-VM of >50 microV followed by an immediate decrease to a level lower than the starting point was seen in 112 of all 269 (42%) patients and in 111 of 149 (75%) of the patients with successful ST-resolution. A reperfusion peak was an independent predictor of better prognosis both in the short- and the long term but had no implications on the prognosis in the subgroup with successful ST-resolution.


CONCLUSIONS
A reperfusion peak was equally common in patients treated with thrombolysis having a successful ST-resolution as observed in studies of patients with successful primary coronary angioplasty. The reperfusion peak was associated with better prognosis and should be recognised as a possible marker of successful reperfusion but can mimic aggravated ischemia.
Nilsson
Johan B
JB
Department of Cardiology, Heart Centre, University Hospital, Umeå, Sweden. johan.nilsson@medicin.umu.se
Jensen
Steen
S
Ottander
Per
P
Näslund
Ulf
U
D000368:Aged; D003326:Coronary Circulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D015425:Myocardial Reperfusion; D015588:Observer Variation; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D015203:Reproducibility of Results; D013548:Sweden / Q000453:epidemiology; D015912:Thrombolytic Therapy; D013997:Time Factors; D016896:Treatment Outcome; D014672:Vectorcardiography