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.
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Služba za internu medicinu, Opća bolnica Karlovac, Karlovac, 2 Zavod za bolesti srca i krvnih žila, Klinička bolnica Dubrava.
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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).
31.
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.
32.
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.
33.
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.
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