Significance of Inducible Ventricular Flutter-Fibrillation After Myocardial Infarction.

Autor: BREMBILLA‐PERROT, BÉATRICE, SUTY‐SELTON, CHRISTINE, CLAUDON, OLIVIER, DE LA CHAISE, ARNAUD TERRIER, LOUIS, PIERRE, NIPPERT, MARC, POPOVIC, BATRIC, BLANGY, HUGUES, KHALDI, EMAD, BELHAKEM, HADJ, BEURRIER, DANIEL, HOURIEZ, PIERRE
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Zdroj: Pacing & Clinical Electrophysiology; Sep2005, Vol. 28 Issue 9, p938-943, 6p, 2 Charts, 2 Graphs
Abstrakt: Aim: The purpose of this study was to determine the factors associated with the induction of ventricular flutter/fibrillation (VFl/VF) and its prognostic significance in post-myocardial infarction. Methods: Programmed ventricular stimulation was performed after myocardial infarction (MI) for syncope (n = 232) or systematically (n = 755); 230 patients had an induced VFl/VF and were followed during 4 ± 2 years. Results: VFl/VF was induced in 49/232 patients (21%) with syncope versus 181/755 asymptomatic patients (24%) (NS) and 94/410 patients (23%) with left ventricular ejection fraction (LVEF) <40% versus 136/577 patients (22.5%) with LVEF >40% (NS). Cardiac mortality was 9%; LVEF was 33 ± 15% in patients who died, 43 ± 13% in alive patients (P < 0.004). In patients with LVEF <40%, induced VFl/VF, mortality rate was 31% in those with syncope, 10% in asymptomatic patients (P < 0.001), because of an increase of deaths by heart failure; patients with LVEF >40% with or without syncope had a low mortality (5% and 3%). After linear logistic regression, VFl/VF and LVEF were predictors of total cardiac mortality, but only LVEF <40% predicted sudden death. Conclusion: Syncope and the level of LVEF did not increase the incidence of VFl/VF induction after MI, but modified the cardiac mortality: induced VF increased total cardiac mortality in patients with syncope and LVEF <40%, but did not increase sudden death. In patients with LVEF >40%, induced VFl/VF has no significance neither in asymptomatic patients nor in those with syncope. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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