Document Detail


Comparison of left ventricular ejection fraction and inducible ventricular tachycardia in ST-elevation myocardial infarction treated by primary angioplasty versus thrombolysis.
MedLine Citation:
PMID:  18178398     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Electrophysiologic studies predict the risk for sudden death after myocardial infarction (MI). Although primary angioplasty has become the preferred method of treatment for ST-elevation MI, intravenous thrombolysis remains the first-line treatment in 30% to 70% of cases worldwide. Rates of ventricular tachyarrhythmias may vary according to type of reperfusion treatment. This study was undertaken to examine the hypothesis that the left ventricular ejection fraction (LVEF) and rates of inducible ventricular tachycardia may be more favorable in treatment with primary angioplasty rather than thrombolysis. Consecutive patients receiving primary angioplasty (n = 225) or thrombolysis (n = 195) for ST-elevation MI were included. The mean LVEF was 48 +/- 12% for the primary angioplasty group and 46 +/- 13% for the thrombolysis group (p = 0.30). The proportion of patients with LVEFs <40% was 30% in the primary angioplasty group and 30% in the thrombolysis group (p = 0.98). Patients with LVEFs <40% underwent electrophysiologic studies. Ventricular tachycardia was inducible in 23 of 66 primary angioplasty patients (34.8%) compared with 21 of 55 (38.1%) thrombolysis patients (p = 0.69). Implantable cardiac defibrillators were inserted in 30 patients, of whom 8 (27%) had appropriate device activations. The mean time from MI to first spontaneous activation was 387 +/- 458 days. In conclusion, patients treated with thrombolysis or primary angioplasty for ST-elevation MIs had similar resultant LVEFs and rates of inducible ventricular tachycardia. There was a surprisingly high rate of spontaneous defibrillator activations, often occurring late after MI.
Authors:
James J H Chong; Anand N Ganesan; Vicki Eipper; Pramesh Kovoor
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  101     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-07     Completed Date:  2008-02-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  153-7     Citation Subset:  AIM; IM    
Affiliation:
Westmead Hospital, Sydney, Australia.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary*
Cohort Studies
Disease-Free Survival
Female
Fibrinolytic Agents / therapeutic use
Humans
Male
Middle Aged
Myocardial Infarction / complications,  drug therapy,  epidemiology,  mortality,  physiopathology,  therapy*
New South Wales / epidemiology
Retrospective Studies
Stroke Volume
Tachycardia, Ventricular / physiopathology*
Thrombolytic Therapy*
Treatment Outcome
Ventricular Dysfunction, Left / physiopathology*
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents

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


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