Exercise-induced ventricular arrhythmias in patients with healed myocardial infarction
| Autor: | Pietro Sangiorgio, Pier Camillo Pavesi, Daniele Bracchetti, Andrea Rubboli, Gianni Casella |
|---|---|
| Rok vydání: | 1993 |
| Předmět: |
Male
medicine.medical_specialty Heart disease Heart Ventricles Myocardial Infarction Myocardial Ischemia Angina Pectoris Electrocardiography Bruce protocol Internal medicine medicine Humans cardiovascular diseases Myocardial infarction Treadmill Aged medicine.diagnostic_test business.industry Incidence (epidemiology) Hemodynamics Middle Aged medicine.disease Exercise Test Tachycardia Ventricular cardiovascular system Cardiology Population study Female Cardiology and Cardiovascular Medicine business Complication Follow-Up Studies |
| Zdroj: | International Journal of Cardiology. 40:229-235 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/0167-5273(93)90005-2 |
| Popis: | Controversy exists about the clinical and prognostic significance of exercise-induced ventricular arrhythmias late after myocardial infarction. The aim of the study was to identify the main clinical and prognostic features of exercise-induced ventricular arrhythmias in out-patients with healed Q-wave myocardial infarction.The study population was 777 consecutive patients who underwent a symptom-limited (Bruce protocol) treadmill test from May 1988 to January 1991 after myocardial infarction (at least 1 year). Clinical and exercise data were prospectively entered in a computerized database and retrospectively two different groups were selected: (1) 228 patients with exercise-induced ventricular arrhythmias; (2) 549 patients without. Incidence and morphology of exercise-induced ventricular arrhythmias, various exercise parameters and a follow-up were evaluated.Patients with exercise-induced ventricular arrhythmias were older (P0.001), had higher blood pressure (P0.03) and peak exercise rate pressure product (P0.00) than the others. No difference was found in the incidence of exercise-ischaemia: either symptomatic or not. When simple (or = 2 Lown) versus complex (or = 3 Lown) exercise-induced ventricular arrhythmias were considered, the latter were more frequent in patients with anterior myocardial infarction, shorter exercise duration (P0.001) and lower exercise rate pressure product, lower ejection fraction and lower incidence of exercise-induced ischaemia. In the follow-up (mean 24 +/- 13 month) there were 24 deaths: five (2.2%) in patients with exercise-induced ventricular arrhythmias and 19 (3.4%) in patients without. Cardiac event rate was similar in both groups.We conclude that in out-patients with healed myocardial infarction exercise-induced ventricular arrhythmias are quite frequent, but they are not associated with exercise-induced ischaemia, either symptomatic or not. Exercise-induced ventricular arrhythmias seem to be related to age or peak workload. Moreover patients with these arrhythmias have no adjunctive negative risk on prognosis. |
| Databáze: | OpenAIRE |
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