title: Characteristics of electrocardiographic repolarization in acute myocardial infarction complicated by ventricular fibrillation.
abstract: OBJECTIVE
  Some de- and re-polarization patterns can reflect an increased risk of ventricular tachyarrhythmias. We studied whether some electrocardiographic (ECG) patterns are able to predict the development of ventricular fibrillation (VF) during acute myocardial infarction (MI).
  
  
  METHODS
  We compared the patterns of ST-T segment of 78 patients who developed VF during acute MI (patient with VF) vs 170 comparable patients with acute MI but with no VF complications.
  
  
  RESULTS
  Of the VF group, 47 developed out-of-hospital VF and 31 developed VF after their admission to the hospital. A steep downsloping ST segment toward a negative T wave with or without a short, flat, or rising portion at the initial portion was observed in 69.2% of the 78 patients: 61.3% in patients with pre-VF and 74.5% in patients with post-VF, vs 9.4% of patients who did not develop VF (P < .0001). In 90.6% of the latter, a typical upward-concave or convex "ischemic" pattern of the ST segment was observed. Thus, the characteristic ST-T patterns were highly associated with VF with a specificity greater than 90%.
  
  
  CONCLUSIONS
  A steep downsloping ST segment may characterize the ECGs of patients who develop VF during acute MI.
authors.affiliation: Niigata University Graduate School of Medical and Dental Science, Niigata, Japan. aizaways@med.niigata-u.ac.jp
authors.forename: Yoshifusa
authors.initials: Y
authors.lastname: Aizawa
authors.forename: Marek
authors.initials: M
authors.lastname: Jastrzebski
authors.forename: Takuya
authors.initials: T
authors.lastname: Ozawa
authors.forename: Kalina
authors.initials: K
authors.lastname: Kawecka-Jaszcz
authors.forename: Piotr
authors.initials: P
authors.lastname: Kukla
authors.forename: Wataru
authors.initials: W
authors.lastname: Mitsuma
authors.forename: Masaomi
authors.initials: M
authors.lastname: Chinushi
authors.forename: Toru
authors.initials: T
authors.lastname: Ida
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Aizawa
authors.forename: Kenji
authors.initials: K
authors.lastname: Ojima
authors.forename: Minoru
authors.initials: M
authors.lastname: Tagawa
authors.forename: Satoru
authors.initials: S
authors.lastname: Fujita
authors.forename: Masaaki
authors.initials: M
authors.lastname: Okabe
authors.forename: Keiichi
authors.initials: K
authors.lastname: Tsuchida
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Miyakita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shimizu
authors.forename: Shogo
authors.initials: S
authors.lastname: Ito
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Imaizumi
authors.forename: Ken
authors.initials: K
authors.lastname: Toba
mesh_terms: D000368:Aged; D015897:Comorbidity; D004562:Electrocardiography / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology*; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014693:Ventricular Fibrillation / Q000175:diagnosis* / Q000453:epidemiology*