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(Circulation. 2000;101:e237.)
© 2000 American Heart Association, Inc.

Circulation Electronic Pages

Sustained Ventricular Arrhythmias in Patients Receiving Thrombolytic Therapy

Stephan Windecker, MD; Christian Seiler, MD

Swiss Cardiovascular Center Bern, University Hospital, 3010 Bern, Switzerland

	Introduction

 
To the Editor:

Newby et al¹ report on the outcome of patients with acute myocardial infarction (MI) receiving thrombolytic therapy in the Global Use of Streptokinase Tissue plasminogen activator for Occluded coronary arteries (GUSTO-I) trial whose course was complicated by ventricular arrhythmias. Patients were classified according to arrhythmia type into the following 3 groups: (1) 1439 patients had ventricular tachycardia (VT) only, (2) 1656 patients had ventricular fibrillation (VF) only, and (3) 1085 patients had both VT and VF. These patient groups were further stratified according to the time of occurrence of the arrhythmia, ie, early (<2 days) or late (>2 days).

When comparing the corresponding patient groups, substantial inconsistencies in the number of patients in each group is noted. Thus, the total number of patients in the early (n=354) and late (n=96) VT only groups in Table 4 is only 450 (31%) of the 1439 patients with VT only in Table 2; the number of patients in the early (n=1229) and late (n=209) VF only group in Table 4 is only 1438 (87%) of the 1656 patients with VF only in Table 2; and the total number of patients with early (n=774) and late (n=159) events in the group with both VT and VF in Table 4 is only 933 (86%) of the 1085 with both VF and VT in Table 2. The calculated mortality rates are also inconsistent. How is it possible that in-hospital mortality is higher in patients with early (34.5%) and late (37.5%) VT only in . . . [Full Text of this Article]

Keith H. Newby, , MD; Trevor Thompson, BS; Amanda Stebbins, MS; Robert M. Califf, MD; Eric J. Topol, MD; Andrea Natale, MD

Electrophysiology Laboratories, Department of Cardiology/F15, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195