title: Factors likely to affect the long-term results of ventricular stimulation after myocardial infarction.
abstract: BACKGROUND
  The results of programmed ventricular stimulation (PVS) may change after myocardial infarction (MI). The objective was to study the factors that could predict the results of a second PVS.
  
  
  METHODS
  Left ventricular ejection fraction (LVEF) and QRS duration were determined and PVS performed within 3 to 14 years of one another (mean 7.5+/-5) in 50 patients studied systematically between 1 and 3 months after acute MI.
  
  
  RESULTS
  QRS duration increased from 120+/-23 ms to 132+/-29 (p 0.04). LVEF did not decrease significantly (36+/-12 % vs 37+/-13 %). Ventricular tachycardia with cycle length (CL) > 220ms (VT) was induced in 11 patients at PVS 1, who had inducible VT with a CL > 220 ms (8) or < 220 ms (ventricular flutter, VFl) (3) at PVS 2. VFl or fibrillation (VF) was induced in 14 patients at PVS 1 and remained inducible in 5; 5 patients had inducible VT and 4 had a negative 2nd PVS. 2. 25 patients had initially negative PVS; 7 had secondarily inducible VT, 4 a VFl/VF, 14 a negative PVS. Changes of PVS were related to initially increasing QRS duration and secondarily changes in LVEF and revascularization but not to the number of extrastimuli required to induce VFl.
  
  
  CONCLUSIONS
  In patients without induced VT at first study, changes of PVS are possible during the life. Patients with initially long QRS duration and those who developed decreased LVEF are more at risk to have inducible monomorphic VT at 2nd study, than other patients.
authors.affiliation: Department of cardiology, CHU of Brabois, Vandoeuvre, France. b.brembilla-perrot@chu-nancy.fr
authors.forename: Beatrice
authors.initials: B
authors.lastname: Brembilla-Perrot
authors.forename: Pierre Yves
authors.initials: PY
authors.lastname: Zinzius
authors.forename: Laurent
authors.initials: L
authors.lastname: Groben
authors.forename: Luc
authors.initials: L
authors.lastname: Freysz
authors.forename: Lucian
authors.initials: L
authors.lastname: Muresan
authors.forename: Jerome
authors.initials: J
authors.lastname: Schwartz
authors.forename: Raphael P
authors.initials: RP
authors.lastname: Martins
authors.forename: Soumaya
authors.initials: S
authors.lastname: Jarmouni
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Nossier
authors.forename: Nicolas
authors.initials: N
authors.lastname: Sadoul
authors.forename: Hugues
authors.initials: H
authors.lastname: Blangy
authors.forename: Arnaud Terrier
authors.initials: AT
authors.lastname: De La Chaise
authors.forename: Pierre
authors.initials: P
authors.lastname: Louis
authors.forename: Olivier
authors.initials: O
authors.lastname: Selton
authors.forename: Daniel
authors.initials: D
authors.lastname: Beurrier
authors.forename: Jean Marc
authors.initials: JM
authors.lastname: Sellal