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

Haghjoo, Majid; Kiani, Reza; Fazelifar, Amir Farjam and Alizadeh, Abolfath (2007) Early risk stratification for arrhythmic death in patients with ST-elevation myocardial infarction. Indian Pacing and Electrophysiology Journal, 7 (1). pp. 19-25. ISSN 0972-6292

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Abstract

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.

EPrint Type:Article
Uncontrolled Keywords:Myocardial Infarction, Sudden Death, Risk Stratification, Heart Rate Variability, Signal-Averaged Electrocardiography, Ejection Fraction, Non-Sustained Ventricular Tachycardia
Subjects:Cardiovascular Diseases > Heart Diseases > Myocardial Ischemia
Cardiovascular Diseases > Heart Diseases > Arrhythmia > Tachycardia
Circulatory and Respiratory Physiology > Cardiovascular Physiology > Cardiovascular Physiologic Phenomena > Hemodynamic Phenomena > Heart Rate
Diagnosis > Diagnostic Techniques and Procedures > Diagnostic Techniques, Cardiovascular > Heart Function Tests
Pathological Conditions, Signs and Symptoms > Pathologic Processes > Death
Diagnosis > Diagnostic Techniques and Procedures > Diagnostic Techniques, Cardiovascular > Heart Function Tests > Electrocardiography
-Journal Repositories > Indian Pacing and Electrophysiology Journal
Health Care Quality, Access, and Evaluation > Quality of Health Care > Health Care Evaluation Mechanisms > Statistics > Probability > Risk
Pathological Conditions, Signs and Symptoms > Pathologic Processes > Arrhythmia
Health Care Quality, Access, and Evaluation > Quality of Health Care > Health Care Evaluation Mechanisms > Statistics > Probability > Risk > Risk Factors
Equipment and Supplies > Electrodes > Defibrillators
ID Code:2656
Deposited By:Indian Pacing and Electrophysiology Journal
Deposited On:03 March 2008

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