| Electrocardiographic factors playing a role in ischemic ventricular fibrillation in ST elevation myocardial infarction are related to the culprit artery. | |
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MedLine Citation:
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PMID: 18180022 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Sudden cardiac death caused by ischemic ventricular fibrillation (VF) associated with ST elevation myocardial infarction (STEMI) is one of the most frequent causes of death. OBJECTIVE: We hypothesized that electrocardiographic (ECG) characteristics differ between STEMI patients with and without ischemic VF. METHODS: Fifty-five first STEMI patients with at least one 12-lead ECG recorded before ischemic VF were compared with 110 first STEMI patients without ischemic VF. Patients with bundle branch blocks or high-degree atrioventricular blocks with escape rhythms were not included. ECG measurements were performed manually after scanning the ECG with the most prominent ST deviation into a software environment and magnifying it 4 times. RESULTS: Mean age was 57 +/- 12 years, and 126 patients were male. No differences were present between the VF and control group regarding baseline, enzymatic, and angiographic data. In left circumflex artery and right coronary artery myocardial infarction, a longer QRS interval (109 +/- 23 ms vs. 91 +/- 16 ms, P = .02 and 107 +/- 24 ms vs. 93 +/- 19, P = .02) was present. In the latter the PR interval (211 +/- 64 ms vs. 160 +/- 36 ms, P <.001) and ST deviation score (3.6 +/- 1.0 mV vs. 1.7 +/- 1.5 mV, P <.001) were also increased. In the left anterior descending artery group no differences in conduction intervals and ST deviation score were present. CONCLUSION: Longer PR and QRS intervals in right coronary artery and left circumflex artery MI fit with the perfusion and activation pattern of the atrioventricular node and the ventricular myocardium. Myocardium perfused by the left anterior descending artery is activated earliest, hiding any intraventricular conduction delay within the QRS complex. Intramural slowed conduction could be a substrate for ischemic VF. |
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Authors:
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Miguel E Lemmert; Jonas S S G de Jong; Antonius M W van Stipdonk; Harry J G M Crijns; Hein J J Wellens; Mitchell W Krucoff; Lukas R Dekker; Arthur A M Wilde; Anton P M Gorgels |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2007-09-19 |
Journal Detail:
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Title: Heart rhythm : the official journal of the Heart Rhythm Society Volume: 5 ISSN: 1547-5271 ISO Abbreviation: Heart Rhythm Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2008-01-08 Completed Date: 2008-05-07 Revised Date: 2009-10-27 |
Medline Journal Info:
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Nlm Unique ID: 101200317 Medline TA: Heart Rhythm Country: United States |
Other Details:
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Languages: eng Pagination: 71-8 Citation Subset: IM |
Affiliation:
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Department of Cardiology, University Hospital Maastricht, Maastricht, The Netherlands. m.lemmert@cardio.azm.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Case-Control Studies Coronary Vessels / pathology*, physiopathology Electrocardiography* Heart Conduction System / physiology* Humans Male Middle Aged Myocardial Infarction / physiopathology* Myocardial Ischemia / complications*, physiopathology Retrospective Studies Tachycardia / physiopathology Ventricular Fibrillation / etiology*, physiopathology |
| Comments/Corrections | |
Erratum In:
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Heart Rhythm. 2008 May;5(5):773 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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