title: Postconditioning attenuates early ventricular arrhythmias in patients with high-risk ST-segment elevation myocardial infarction.
abstract: BACKGROUND
  It has been demonstrated that postconditioning (postcon), brief episodes of ischemia during reperfusion period, in patients with ST-segment elevation myocardial infarction (STEMI) confers protection against ischemia-reperfusion injury and as a result, postcon might reduce infarct size. However, whether postcon may exert its beneficial effect on STEMI patients by reducing the occurrence of early malignant ventricular arrhythmias (VA) is still unknown. The aim of the study was to evaluate the influence of postcon on the presence of VA in early presenters with high-risk STEMI treated with primary coronary intervention (PCI).
  
  
  METHODS
  Seventy-five STEMI patients treated with primary PCI within 6h from symptoms onset were randomly assigned to postcon group (n=37) or conventional PCI group (n=38) in 1:1 ratio. Postcon was performed immediately after restoration of coronary flow as follows: the angioplasty balloon was inflated 4× 1min with low-pressure inflations, each separated by 1min of deflation. After that the patients were continuously monitored electrographically for 48h. The end-point of the study was the occurrence of VA (ventricular fibrillation-VF, sustained ventricular tachycardia-sVT, non-sustained ventricular tachycardia-nsVT) within 48h after the procedure.
  
  
  RESULTS
  In the postcon group, the occurrence of VAs was significantly lower: VF-3, sVT-0, nsVT-15, i.e. (18 patients - 48.6%) in comparison to control group: VF-2, sVT-4, nsVT-23 (29 patients - 76.3%); p=0.013. The occurrence of accelerated idioventricular rhythm varied insignificantly between both groups (postcon - 45.9% vs control - 34.2%; p=NS).
  
  
  CONCLUSIONS
  Postcon may reduce the occurrence of malignant VA in patients with STEMI treated with primary PCI.
authors.affiliation: 1st Department of Cardiology, University of Medical Sciences, Poznan, Poland. Electronic address: aaraszkiewicz@interia.pl.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Araszkiewicz
authors.affiliation: 1st Department of Cardiology, University of Medical Sciences, Poznan, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Grygier
authors.affiliation: 1st Department of Cardiology, University of Medical Sciences, Poznan, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Pyda
authors.affiliation: 1st Department of Cardiology, University of Medical Sciences, Poznan, Poland.
authors.forename: Justyna
authors.initials: J
authors.lastname: Rajewska
authors.affiliation: 1st Department of Cardiology, University of Medical Sciences, Poznan, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Lesiak
authors.affiliation: 1st Department of Cardiology, University of Medical Sciences, Poznan, Poland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Grajek
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D057775:Ischemic Postconditioning / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000628:therapy*; D015428:Myocardial Reperfusion Injury / Q000209:etiology / Q000517:prevention & control*; D017180:Tachycardia, Ventricular / Q000517:prevention & control; D014693:Ventricular Fibrillation / Q000517:prevention & control
keywords: Myocardial infarction; Postconditioning; Ventricular arrhythmias