1981
DOI: 10.1136/hrt.45.6.717
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Analysis of prognostic significance of ventricular arrhythmias after myocardial infarction. Shortcomings of Lown grading system.

Abstract: The Lown grading system for ventricular arrhythmias has been used in observational and experimental studies of ischaemic heart disease. This grading system uses three levels of ventricular premature depolarisation frequency and four complex features to assign patients to one of seven grades. We tested several of the major assumptions of the Lown grading system in a group of 400 patients who had recently experienced acute myocardial infarction. The Lown grading system assumes that the frequency of ventricular e… Show more

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Cited by 104 publications
(27 citation statements)
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“…As noted by Bigger and Weld [95] with particular reference to early-cycle VPCs (Lown grade 5), these observations are of great importance in the design of therapeutic trials in the postinfarct population. Since substantial heterogeneity of risk clearly exists among presumed 'high-risk' population sub sets identified by VPC complexity alone, po tential harm to low-risk patients included in intervention trials must be weighed, and the effect of these patients on assessing the results of intervention must be considered.…”
Section: Classification and Grading Of Ventricular Arrhythmiasmentioning
confidence: 99%
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“…As noted by Bigger and Weld [95] with particular reference to early-cycle VPCs (Lown grade 5), these observations are of great importance in the design of therapeutic trials in the postinfarct population. Since substantial heterogeneity of risk clearly exists among presumed 'high-risk' population sub sets identified by VPC complexity alone, po tential harm to low-risk patients included in intervention trials must be weighed, and the effect of these patients on assessing the results of intervention must be considered.…”
Section: Classification and Grading Of Ventricular Arrhythmiasmentioning
confidence: 99%
“…and a very-high-risk subset was identified from the combination of these fea tures. Furthermore, stratification of mortal ity risk within Lown grade 5 (early-cycle VPCs) was extreme, ranging from 9% among patients with infrequent VPCs and no other 'complex' features, to as high as 59% when frequent VPCs and other complex patterns also occurred [95].…”
Section: Classification and Grading Of Ventricular Arrhythmiasmentioning
confidence: 99%
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“…Thus, reduced heart rate variability (HRV) measured 1-2 weeks after MI has been shown to be a powerful and independent predictor of short-and medium-term mortality (1)(2)(3). Ventricular tachycardia (VT) is known to identify patients at increased risk for future sudden death and ventricular brillation (4)(5)(6). Finally, episodes of transient ST-segment elevation (ST : ) during daily life early after MI appear to be associated with subsequent cardiac death (CD) (7).…”
mentioning
confidence: 99%
“…Of the 18 not referred for PES, there were 13 males and 5 females, with a mean age of 63 ± 9 years. The group referred for PES showed 15 % to have had a cardiac arrest, 62 % to have symptomatic VT and 23 % to have had asymptomatic VT on Holter monitoring (5)(6)(7)(8)(9)(10)(11)(12)(13)(14) days post infarction). In contrast, none of the patients in the non-referred group had a cardiac arrest, while half had symptomatic VT and half had asymptomatic VT on Holter.…”
mentioning
confidence: 99%