Document Detail

Characteristics of patients with nonfatal cardiac arrest 3 to 180 days after acute myocardial infarction.
MedLine Citation:
PMID:  8213505     Owner:  NLM     Status:  MEDLINE    
Patients who survive a tachyarrhythmic cardiac arrest in the first 6 months after acute myocardial infarction (AMI) are at risk for recurrent arrests, but the magnitude, timing and characteristics of this phenomenon are unknown. This study characterizes the nature of recurrent tachyarrhythmic cardiac arrests in the absence of reversible factors or new myocardial necrosis in patients between 3 and 180 days after AMI. We retrospectively assessed 28 patients (mean age 61 +/- 12 years) who survived an initial cardiac arrest a median of 10 days after AMI. Mean left ventricular ejection fraction was 36 +/- 9%. Fourteen patients (50%) had at least 1 recurrence of cardiac arrest, and 10 had > 2 arrests. Almost all (92%) recurrent cardiac arrests occurred within 5 days of the preceding arrest, and the high-risk periods were similar after the first, second or third cardiac arrest. Very fast ventricular tachycardia (mean cycle length 212 +/- 30 ms) was the documented responsible arrhythmia in 44 of 51 cardiac arrests. The morphology was either polymorphic, monomorphic or sinusoidal. No clinical or laboratory values could be found that predicted whether a patient would have a recurrent arrest. Nineteen patients (68%) survived to leave the hospital and have been followed for up to 96 months. For these, actuarial 5-year overall survival was 76% and actuarial 5-year arrhythmia-free probability was 80%. Thus, patients who survive a cardiac arrest in the first 6 months after AMI are at high risk of recurrent cardiac arrest for a further 5 days, and the arrests are due to characteristically fast ventricular tachycardias.(ABSTRACT TRUNCATED AT 250 WORDS)
R S Sheldon; D G Wyse; L B Mitchell; A M Gillis; K M Kavanagh; H J Duff
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  72     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1993 Oct 
Date Detail:
Created Date:  1993-11-24     Completed Date:  1993-11-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  753-8     Citation Subset:  AIM; IM    
Cardiovascular Research Group, University of Calgary, Alberta, Canada.
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MeSH Terms
Actuarial Analysis
Aged, 80 and over
Cardiac Pacing, Artificial
Follow-Up Studies
Heart Arrest / etiology,  mortality,  physiopathology*
Middle Aged
Myocardial Infarction / complications*
Retrospective Studies
Stroke Volume
Survival Analysis
Tachycardia, Ventricular / complications,  therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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