Aim To determine the impact of infarct localization and types of reperfusion therapy on the frequency of ventricular premature beats (VPBs) in patients with acute myocardial infarction (AMI) and reduced left ventricular ejection fraction (LVEF). Methods A total of 705 patients with acute ST elevation myocardial infarction (STEMI) were divided according to the infarct localization (anteroseptal, anterolateral, inferior and posterior) and reperfusion therapy (fibrinolysis or percutaneous coronary intervention with stenting) into two groups: LVEF<45% was an experimental group and LVEF>45% was a control group. The occurrence of VPBs<10 per hour was defined as a non-significant, and the occurrence of VPBs>10 per hour defined as a significant. Results In patients with fibrinolysis therapy and LVEF<45% significant number of VPBs were in anteroseptal (p=0.017), anterolateral (p<0.001) and posterior AMI (p<0.001), but in patients with percutaneous coronary intervention (PCI) and LVEF<45% significant number of VPBs were only in anteroseptal AMI (p=0.001) localization. Conclusion In patients with reduced ejection fraction in AMI, treatment with PCI method has a better antiarrhythmic effect compared to fibrinolysis treatment.
Schuster E, Bulkley B. Ischemia at a distance after acute myocardial infarction: a cause of early postinfarction angina. Circulation 1980:509–15.
2
Keeley E, Boura J, Grines C. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. Lancet 2003:13–20.
3
Breithard L, Schwarzmaier J, Borggrefe M, Haerten K, Seipel L. Prognostic significance of late ventricular potentials after acute myocardial infarction. Eur Heart J 1983:487–95.
4
Pascale P, Schlaepfer J, Oddo M, Schaller M, Vogt P, Fromer P, et al. Ventricular arrhythmia in coronary artery disease: limits of a risk stratification strategy based on the ejection fraction alone and impact of infarct localization. Europace 2009:1639–46.
5
Christoffels V, Moorman A. Why Are Some Regions of the Heart More Arrhythmogenic Than Others? Circulation: Arrhythmia and Electrophysiology 2009:195–207.
6
Dave J, Lakhia R, Jha S. Ventricular Premature Complexes 15AD.
7
Bainey K, Fu Y, Wagner G, Goodman S, Ross A, Granger C, et al. Spontaneous reperfusion in ST-elevation myocardial infarction: comparison of angiographic and electrocardiographic assessments. Am Heart J 2008:248–55.
8
Bainey K, Fu Y, Granger C, Hamm C, Holmes D, Neil O, et al. Benefit of angiographic spontaneous reperfusion in STEMI: does it extend to diabetic patients? Heart 2009:1331–6.
9
Fujita M, Nakae I, Kihara Y, Hasegawa K, Nohara R, Ueda K. Determinants of collateral development in patients with acute myocardial infarction. Clin Cardiol 1999:595–9.
10
Weaver W, Simes R, Betriu A, Grines C, Zijlstra F, Garcia E, et al. Comparison of primary coronary angioplasty and intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review. JAMA 1997:2093–8.
11
Hofsten D, Wachtell K, Lund B, Molgaard H. Egstrup K. Prevalence and prognostic implications of non-sustained ventricular tachycardia in ST-segment elevation myocardial infarction after revascularization with either fibrinolysis or primary angioplasty. Eur Heart J 2007:407–14.
12
Josip Vincelj n.d.:4.
13
Služba za internu medicinu, Opća bolnica Karlovac, Karlovac, 2 Zavod za bolesti srca i krvnih žila, Klinička bolnica Dubrava n.d.
14
Zdravstveno Veleučilište, Zagreb, Medicinski, Osijek, Sveučilište J, Strossmayera. Osijek; Hrvatska SAŽETAK Cilj Odrediti utjecaj lokalizacije infarkta i reperfuzijske terapije na učestalost ventrikulskih ekstrasistola (VES) kod pacijenata s akutnim infarktom miokarda (AIM) i reduciranom ejekcijskom frakcijom lijevog ventrikla (EFLV) n.d.
15
Metode Ukupno je 705 bolesnika s akutnim infarktom miokarda i ST elevacijom (STEMI) podijeljeno prema lokalizaciji infarkta (anteroseptalni, anterolateralni, inferiorni i posteriorni) i reperfuzijskoj terapiji (fibrinoliza ili perkutana koronarna intervencija sa stentom) u dvije grupe: EFLV<45% kao ispitivana grupa, te EFLV>45% kao kontrolna grupa n.d.
16
Rezultati U pacijenata s fibrinolizom i EFLV<45% značajan broj VES-a bio je u anteroseptalnom (p=0,017), anterolateralnom (p<0,001) i posteriornom AIM-u (p<0,001), a u pacijenata s perkutanom koronarnom intervencijom (PCI) i EFLV<45% značajan broj VES-a bio je samo u anteroseptalnoj AIM n.d.
17
Zaključak U pacijenata sa smanjenom ejekcijskom frakcijom u AIM-u, tretman s PCI metodom imao je bolji antiaritmički efekat u odnosu na fibrinolitički tretman. Ključne riječi: fibrinoliza, perkutana koronarna intervencija n.d.
18
Olgin J, Zipes D. Specific Arrhythmias: Diagnosis and Treatment 2005:838–45.
19
Gibson C, Ryan K, Kelley M, Rizzo M, Mesley R, Murphy S. Methodologic drift in the assessment of TIMI grade 3 flow and its implications with respect to the reporting of angiographic trial results. Am Heart J 1999:1179–84.
20
Stone P, Raabe D, Jaffe A, Gustafson N, Müller J, Turi Z. Prognostic significance of location and type of myocardial infarction: independent adverse outcome associated with anterior location. J Am Coll Cardiol 1998:453–63.
21
Bluazite I, Brazdzionyte J, Bluzhas J, Mickeviciene A. Signal-averaged electrocardiogram peculiarities of the first and recurrent myocardial infarction. JHong Kong Coll Cardiol 1997:119–25.
22
Terkelsen C, Christiansen E, Sorensen J, Kristensen S, Lassen J, Thuessen L. Primary PCI as the preferred reperfusion therapy in STEMI: it is a matter of time. Heart 2009:362–9.
23
Solomon S, Zelenkofske S, Mcmurray J, Finn P, Velazqueze E, Ertl G. Sudden death in patients with myocardial infarction and left ventricular dysfunction, heart failure, or both. N Engl J Med 2005:2581–8.
24
John R, Tedrow U, Koplan B, Albert C, Epstein L, Sweeney M, et al. Ventricular arrhythmias and sudden cardiac death. Lancet 2012:1520–9.
25
Eckardt L, Breithardt G. Drug-induced ventricular tachycardia. From Cell to Bedside 6 Th Ed Elsevier Saunders n.d.:1001–8.
26
Cha Y, Lee G, Klarich K, Grogan M. Premature ventricular contraction-induced cardiomyopathy. Circulation: Arrhythmia and Electrophysiology 2012:229–36.
27
Ventricular premature beats. The Merck Manuals: The Merck Manual for Health Care Professionals 16AD.
28
Manolis A. Ventricular premature beats 16AD.
29
Breithardt G, Borggrefe M, Martinez-Rubio A, Budde T. Pathophysiological mechanisms of ventricular tachyarrhythmias. Eur Heart J 1989:9–18.
30
Newbi K, Thompson T, Stebbins A, Topol E, Califf R, Natale A. Sustained ventricular arrhythmias in patients receiving thrombolytic therapy: incidence and outcomes. Circulation 1998:2567–73.
31
Volpi A, Cavalli A, Turato R, Barlera S, Santoro E, Negri E. Incidence and short-term prognosis of late sustained ventricular tachycardia after myocardial infarction: results of the Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico (GI-SSI-3) Data Base. Am Heart J 2001:87–92.
32
Timmer J, Breet N, Svilaas T, Haaksma J, Van Gelder I, Zijlstra F. Predictors of ventricular tachyarrhythmia in high-risk myocardial infarction patients treated with primary coronary intervention. Neth Heart J 2010:122–8.
33
Drőgeműller A, Seidl K, Schiele R, Schneider S, Gitt A, Gotwik M. Prognostic value of non-sustained ventricular tachycardias after acute myocardial infarction in the thrombolytic era: importance of combination with frequent ventricular premature beats. Z Kardiol 2003:164–72.
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