Early risk stratification for arrhythmic death in patients with ST-elevation myocardial infarction

Haghjoo, M. and Kiani, R. and Fazelifar, A.F. and Alizadeh, A. and Emkanjoo, Z. and Sadr-Ameli, M.A. (2007) Early risk stratification for arrhythmic death in patients with ST-elevation myocardial infarction. Indian Pacing and Electrophysiology Journal, 7 (1). pp. 19-25.

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Background: Sudden cardiac death is a leading cause of death in patients with ST-elevation myocardial infarction (MI). According to high cost of modern therapeutic modalities it is of paramount importance to define protocols for risk stratification of post-MI patients before considering expensive devices such as implantable cardioverter-defibrillator. Methods: One hundred and thirty seven patients with acute ST-elevation MI were selected and underwent echocardiographic study, holter monitoring and signal-averaged electrocardiography (SAECG). Then, the patients were followed for 12 ±3 months. Results: During follow-up, 13 deaths (9.5) occurred; nine cases happened as sudden cardiac death (6.6). The effect of ejection fraction (EF) less than 40 on occurrence of arrhythmic events was significant (P<0.001). Sensitivity and positive predictive value of EF<40 was 100 and 76.95 respectively. Although with lesser sensitivity and predictive power than EF<40, abnormal heart rate variability (HRV) and SAECG had also significant effects on occurrence of sudden death (P=0.02 and P=0.003 respectively). Nonsustained ventricular tachycardia was not significantly related to risk of sudden death in this study (P=0.20). Conclusions: This study indicated that EF less than 40 is the most powerful predictor of sudden cardiac death in post MI patients. Abnormal HRV and SAECG are also important predictors and can be added to EF for better risk stratification.

Item Type: Article
Additional Information: cited By 5
Uncontrolled Keywords: streptokinase, acute heart infarction; adult; aged; article; cardiovascular risk; controlled study; coronary artery bypass surgery; Doppler echocardiography; female; fibrinolytic therapy; follow up; heart arrhythmia; heart death; heart left ventricle ejection fraction; heart muscle revascularization; heart rate variability; heart ventricle tachycardia; Holter monitoring; human; major clinical study; male; percutaneous coronary intervention; prediction; risk assessment; sensitivity and specificity; signal averaged electrocardiography; ST segment elevation; sudden death
Subjects: WG Cardiovascular System
Divisions: School of Rehabilitation Sciences
Depositing User: parto mrs bakhtminoo
Date Deposited: 26 Feb 2019 11:20
Last Modified: 26 Feb 2019 11:20
URI: http://eprints.iums.ac.ir/id/eprint/12261

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