This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Schulze, R. A. Articles by Pitt, B. Search for Related Content PubMed PubMed Citation Articles by Schulze, R. A., Jr Articles by Pitt, B.

Circulation, Vol 55, 839-843, Copyright © 1977 by American Heart Association

ARTICLES

Left ventricular and coronary angiographic anatomy. Relationship to ventricular irritability in the late hospital phase of acute myocardial infarction

RA Schulze Jr, JO Humphries, LS Griffith, H Ducci, S Achuff, MG Baird, ED Mellits and B Pitt

Late hospital phase ventricular arrhythmias in acute myocardial infarction (MI) have been associated with a high incidence of sudden death following hospital discharge. Thirty-eight patients were studied 10-24 days following onset of symptoms of MI. Each patient had a 24- hour ambulatory ECG tape recording and left ventricular and coronary angiography performed. Patients with complicated ventricular arrhythmias (multiform, coupled, R on T VPCs or ventricular tachycardia), when compared to those with uncomplicated ventricular arrhythmias (unifocal or no VPCs), had a greater number of proximally narrowed major coronary arteries (P less than 0.001), a higher coronary "score" (P less than 0.001), a greater incidence of previous myocardial infarction (P less than 0.005), a greater percentage of abnormal left ventricular segments 86% vs 69% (P less than 0.001) and lower ejection fractions. These data suggest that late hospital phase survivors of MI with complicated ventricular arrhythmias have more extensive coronary artery disease with greater left ventricular dysfunction than survivors with uncomplicated ventricular arrhythmias. This more extensive disease may result in increased areas of ischemic myocardium and may help explain the refractoriness of these arrhythmias to pharmacologic therapy.

This article has been cited by other articles:

				G A Lanza, D Cianflone, A G Rebuzzi, G Angeloni, A Sestito, G Ciriello, G La Torre, F Crea, A Maseri, and for the Stratificazione Prognostica dell'Angina In Prognostic value of ventricular arrhythmias and heart rate variability in patients with unstable angina Heart, August 1, 2006; 92(8): 1055 - 1063. [Abstract] [Full Text] [PDF]

				K. M. Rosen, S. P. Swiryn, E. A. Palileo, and B. Strasberg Treatment of Asymptomatic Ventricular Dysrhythmia in Patients With schemic Heart Disease Arch Intern Med, November 1, 1980; 140(11): 1419 - 1421. [Abstract] [PDF]