Document Detail

Early Repolarization Increases the Occurrence of Sustained Ventricular Tachyarrhythmias and Sudden Death in the Chronic Phase of an Acute Myocardial Infarction.
MedLine Citation:
PMID:  24863485     Owner:  NLM     Status:  Publisher    
BACKGROUND: -We recently showed that the presence of early repolarization (ER) increases the risk of ventricular fibrillation occurrences in the early phase of acute myocardial infarction (AMI). This study aimed to clarify whether an association exists between ER and occurrences of ventricular tachyarrhythmias (VT/VF) or sudden death in the chronic phase of AMI.
METHODS AND RESULTS: -This study retrospectively enrolled 1,131 patients (67±12 years; 862 men) with AMIs surviving 14 days post-AMI. The primary endpoint was the occurrence of sustained VT/VF or sudden death >14 days after the AMI onset. We evaluated the presence of ER from the pre-discharge ECG (mean 10±3 days post-AMI). ER was defined as an elevation of the terminal portion of the QRS complex of >0.1 mV in inferior or lateral leads. After a median follow-up of 26.2 months, 26 patients had an episode of VT/VF or sudden death. A multivariable Cox regression analysis revealed the presence of ER (hazard ratio [HR] 5.37; 95% confidence interval [CI] 2.27-12.69; p<0.001), Killip class on admission of >I (HR 2.75; 95%CI 1.24-6.07; p=0.013), and a left ventricular ejection fraction of <35% (HR 11.83; 95%CI 5.16-27.13; p<0.001) were significantly associated with event occurrences. As features of the ER pattern, ER in the inferior leads, high-amplitude ER, a notched morphology, and ER without ST-segment elevation were associated with an increased risk of event occurrences.
CONCLUSIONS: -ER observed at a mean of 10 days post-AMI may be a marker for a subsequent risk of VT/VF or sudden death.
Yoshihisa Naruse; Hiroshi Tada; Yoshie Harimura; Mayu Ishibashi; Yuichi Noguchi; Akira Sato; Tomoya Hoshi; Yukio Sekiguchi; Kazutaka Aonuma
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-26
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  -     ISSN:  1941-3084     ISO Abbreviation:  Circ Arrhythm Electrophysiol     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-5-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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