Document Detail

Is arrhythmogenicity related to the speed of reperfusion during thrombolysis for myocardial infarction?
MedLine Citation:
PMID:  7682509     Owner:  NLM     Status:  MEDLINE    
The objective of this study was to relate the number of ventricular arrhythmias (VA) to the normalization time of the ST segment during thrombolysis for acute myocardial infarction. The 24 h Holter recordings, begun on start of intravenous thrombolytic therapy, and the 12-lead electrocardiograms of 41 patients with a patent infarct-related artery according to coronary angiography were analysed. The mean time from onset of chest pain to angiography was 30.5 +/- 3.1 h, < or = 24 h in 59%. The normalization time of the ST segment, assessed by the time of decrease of ST segment elevation from start of Holter recording to normal or steady state was < or = 60 min in 13 patients (group 1), 60 to 180 min in 15 patients (group 2) and > 180 min in 13 patients (group 3). The incidence of VA was similar in all groups, except for ventricular tachycardias (VT) > 15 beats (group 1:69%, group 2:13%, group 3:15%, P = 0.002). The frequency of accelerated idioventricular rhythms (AIVR), early AIVR (< or = 6 h) and of VT was significantly higher in group 1 than in group 3 with a 8-, 30- and 6-fold increase, respectively (back transformed mean). We conclude that the number of VAs is related to the normalization time of the ST segment during reperfusion. This may suggest that faster reflow is more arrhythmogenic.
V Gressin; A P Gorgels; Y Louvard; H Lardoux; R H Bigelow
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European heart journal     Volume:  14     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1993 Apr 
Date Detail:
Created Date:  1993-05-20     Completed Date:  1993-05-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  516-20     Citation Subset:  IM    
Cardiology Department, Gilles de Corbeil Hospital, Corbeil-Essonnes, France.
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MeSH Terms
Cardiac Complexes, Premature / diagnosis,  etiology*
Electrocardiography, Ambulatory
Middle Aged
Myocardial Infarction / drug therapy*
Myocardial Reperfusion / methods
Myocardial Reperfusion Injury / etiology*
Streptokinase / therapeutic use
Tachycardia, Ventricular / diagnosis,  etiology*
Thrombolytic Therapy / adverse effects*
Time Factors
Tissue Plasminogen Activator / therapeutic use
Reg. No./Substance:
EC 3.4.-/Streptokinase; EC Plasminogen Activator

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