Document Detail

Mechanisms, prediction and treatment of ventricular tachyarrhythmias occurring late after myocardial infarction.
MedLine Citation:
PMID:  17448725     Owner:  NLM     Status:  MEDLINE    
Studies from the 1980s, refined in the intervening years, have examined the milieu for ventricular tachycardia (VT) and ventricular fibrillation (VF) occurring late after acute myocardial infarction (AMI). The arrhythmogenic substrate appears to be patchy areas of fibrous tissue interdigitating with viable bundles of myocardium which have distorted orientation and tortuous interconnections. These promote conduction delay in sinus rhythm. Factors found to promote induction of VT rather than VF are longer conduction delay in sinus rhythm, larger infarct size, a more ragged infarct edge and longer ventricular extrastimulus coupling intervals. Predictors of spontaneous VT and VF late after AMI include inducible VT at electrophysiological studies (EPS), delayed conduction in sinus rhythm detected as late potentials on signal-averaged surface electrocardiogram (ECG), and low left ventricular ejection fraction (LVEF). Treatments of propensity for VT or VF after AMI include insertion of a defibrillator (ICD), which has the best track record, antiarrhythmic medication (less reliable), and ablation or excision of arrhythmogenic substrate (for refractory VT and VF).
A Robert Denniss; David A B Richards
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-04-19
Journal Detail:
Title:  Heart, lung & circulation     Volume:  16     ISSN:  1443-9506     ISO Abbreviation:  Heart Lung Circ     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-23     Completed Date:  2007-08-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100963739     Medline TA:  Heart Lung Circ     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  156-61     Citation Subset:  IM    
Westmead Hospital, Westmead, NSW 2145, Australia.
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MeSH Terms
Anti-Arrhythmia Agents / therapeutic use*
Catheter Ablation
Defibrillators, Implantable
Myocardial Infarction / complications*
Predictive Value of Tests
Tachycardia, Ventricular / etiology*,  therapy
Time Factors
Ventricular Fibrillation / etiology*,  therapy
Reg. No./Substance:
0/Anti-Arrhythmia Agents

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

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