title: Influence of the mode of management of acute myocardial infarction on the inducibility of ventricular tachyarrhythmias with programmed ventricular stimulation after myocardial infarction.
abstract: BACKGROUND
  Programmed ventricular stimulation (PVS) is a technique for screening patients at risk for ventricular tachycardia (VT) after myocardial infarction (MI), but the results might be difficult to interpret.
  
  
  OBJECTIVE
  To investigate the results of PVS after MI, according to date of completion.
  
  
  METHODS
  PVS results were interpreted according to the mode of MI management in 801 asymptomatic patients: 301 (group I) during the period 1982-1989, 315 (group II) during 1990-1999, and 185 (group III) during 2000-2010. The periods were chosen based on changes in MI management. Angiotensin-converting enzyme (ACE) inhibitors had been given since 1990; primary angioplasty was performed routinely since 2000. The PVS protocol was the same throughout the whole study period.
  
  
  RESULTS
  Group III was older (61 +/- 11 years) than groups I (56 +/- 11) and II (58 +/- 11) (P < 0.002). Left ventricular ejection fraction (LVEF) was lower in group III (36.5 +/- 11%) than in groups I (44 +/- 15) and II (41 +/- 12) (P < 0.000). Monomorphic VT < 270 beats/min was induced as frequently in group III (28%) as in group II (22.5%) but more frequently than in group I (20%) (P < 0.03). Ventricular fibrillation and flutter (VF) was induced less frequently in group III (14%) than in groups I (28%) (P < 0.0004) and II (30%) (P < 0.0000). Low left ventricular ejection fraction (LVEF) and date of inclusion (before/after 2000) were predictors of VT or VF induction on multivariate analysis.
  
  
  CONCLUSIONS
  Induction of non-specific arrhythmias (ventricular flutter and fibrillation) was less frequent than before 2000, despite the indication of PVS in patients with lower LVEF. This decrease could be due to the increased use of systematic primary angioplasty for MI since 2000.
authors: Béatrice
authors: B
authors: Brembilla-Perrot
authors: Olivier
authors: O
authors: Huttin
authors: Bérivan
authors: B
authors: Azman
authors: Jean M
authors: JM
authors: Sellal
authors: Jérôme
authors: J
authors: Schwartz
authors: Arnaud
authors: A
authors: Olivier
authors: Hugues
authors: H
authors: Blangy
authors: Nicolas
authors: N
authors: Sadoul
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000379:methods / Q000639:trends; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000628:therapy; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D054141:Ventricular Flutter / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D016277:Ventricular Function, Left; D055815:Young Adult
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors