Arrhythmias in the Assessment of Coronary Artery Reperfusion Following Thrombolytic Therapy

Gore, Joel M.; Ball, Steven P.; Corrao, Jeanne M.; Goldberg, Robert J.

doi:10.1378/chest.94.4.727

Cited by 20 publications

(2 citation statements)

References 13 publications

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“…Various studies have shown the association of sinus bradycardia and accelerated idioventricular rhythm with the occurrence of myocardial reperfusion, 8,9 as well as the lack of specificity of the ventricular arrhythmias as reperfusion markers. [10][11][12] However, it is not completely clear whether VT is a marker of inadequate myocardial perfusion after thrombolysis; 13 therefore, a more aggressive attitude has been recommended in these patients based on their high mortality rate.…”

Section: Discussion Sustained Ventricular Tachycardia As a Marker Of mentioning

confidence: 99%

Sustained ventricular tachycardia as a marker of inadequate myocardial perfusion during the acute phase of myocardial infarction

Sala

Bárcena

Rota

et al. 2002

Clinical Cardiology

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SummaryBackground: Sustained ventricular tachycardia (VT) complicating the acute phase of myocardial infarction (AMI) is a quite rare event but with short-term unfavorable prognosis. The clinical characteristics as well as the therapeutic implications have not yet been well defined.Hypothesis: This paper attempts to prove that VT may be considered a marker of inadequate myocardial perfusion after thrombolysis.Methods: To assess the clinic-electroangiographic characteristics and prognosis of patients with VT occurring within the first 4 days of an AMI, a case-control study was carried out in 23 patients from a total of 1,100 patients (1.9%) hospitalized with AMI between March 1993 and July 1997. These patients were compared with a control group of 131 patients hospitalized consecutively. A statistical analysis was made using the chi-square test, t-test, and logistic regression.Results: There were no differences among groups with regard to age, gender, and area of necrosis. Average time for the onset of VT was 26 h (range 0-92 h). Sixteen patients underwent coronary angiography: 4 patients had left main coronary artery disease, 2 had single-vessel disease, 8 had lesions in two vessels, and 2 had triple-vessel disease. Univariate analysis showed that patients with VT had a higher incidence of crea-

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Section: Discussion Sustained Ventricular Tachycardia As a Marker Of mentioning

confidence: 99%

Sustained ventricular tachycardia as a marker of inadequate myocardial perfusion during the acute phase of myocardial infarction

Sala

Bárcena

Rota

et al. 2002

Clinical Cardiology

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“…Studies in the thrombolytic era have suggested that AIVR is a marker of reperfusion following thrombolytic therapy [26][27][28][29], although this has debated in the literature [29][30][31]. Explanations for these differences include the definition of AIVR used, the possible failure to record "benign" arrhythmias, the use of both intracoronary and intravenous thrombolytics, and the use of lidocaine in some trials [27].…”

Section: Incidence and Prognosismentioning

confidence: 99%

Prognosis and Treatment of Ventricular Arrhythmias Following Myocardial Infarction

Laidlaw¹,

Homoud²,

Weinstock³

et al. 2007

CCR

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Ventricular arrhythmias are common in the setting of acute myocardial infarction (AMI). In today's era of reperfusion therapy, anti-arrhythmic medications, and Implantable Cardioverter Defibrillators (ICDs), an understanding of these arrhythmias and the prognosis of patients with these arrhythmias is essential in determining the proper treatment strategy. In general, ventricular arrhythmias occurring in the first 48 hours (early) following admission for AMI do not predict an increased risk of arrhythmias in follow-up. While early sustained ventricular tachycardia and ventricular fibrillation predict increased in-hospital mortality, the medium and long-term mortality is comparable to control populations in most studies. In contrast, ventricular arrhythmias occurring after 48 hours (late) generally predict an increased risk of arrhythmias and sudden cardiac death. This review focuses on the different ventricular arrhythmias which occur in both the early and late stages following myocardial infarction. Special attention is made to the incidence and prognosis of these arrhythmias, and how this relates to current treatment recommendations.

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Patient Selection for Thrombolytic Therapy for Evolving Myocardial Infarction

Arnold¹,

Boersma²,

Vlugt³

et al. 1997

Developments in Cardiovascular Medicine

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Arrhythmias in the Assessment of Coronary Artery Reperfusion Following Thrombolytic Therapy

Cited by 20 publications

References 13 publications

Sustained ventricular tachycardia as a marker of inadequate myocardial perfusion during the acute phase of myocardial infarction

Sustained ventricular tachycardia as a marker of inadequate myocardial perfusion during the acute phase of myocardial infarction

Prognosis and Treatment of Ventricular Arrhythmias Following Myocardial Infarction

Patient Selection for Thrombolytic Therapy for Evolving Myocardial Infarction

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