Prognostic value of non-sustained ventricular tachycardias after acute myocardial infarction in the thrombolytic era: importance of combination with frequent ventricular premature beats |
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Authors: | Drögemüller A Seidl K Schiele R Schneider S Gitt A Gottwik M von Leitner E R Poppe C Rettig-Stürmer G Senges J;MITRA study Group |
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Institution: | Herzzentrum Ludwigshafen, Kardiologie, Bremserstr. 79 67063 Ludwigshafen, Germany. Droegema@klilu.de |
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Abstract: | PURPOSE: of this study was to re-evaluate the association between ventricular arrhythmias and long-term mortality after acute myocardial infarction (AMI) in the thrombolytic era. METHODS: MITRA (maximal individual therapy in patients with AMI) is a multicenter registry of 54 hospitals in Germany investigating patients with AMI. RESULTS: 2420 patients received Holter ECG. Positive Holter ECG was defined: > or =10 ventricular premature beats (VPB)/h, or > or =4 couplets/d, or > or =1 non-sustained ventricular tachycardia (nsusVT)/d, or their combination. Mortality rates (median 17 months) were 6.5% without ventricular arrhythmias, with > or =10 VPB/h 15.2% and with the combination of > or =10 VPB/h plus either > or =4 couplets/d or > or =1 nsusVT/d 23.4%. In multivariate analysis, none of the ventricular arrhythmias alone correlated with mortality. There was a significant association between mortality and the combination of > or =10 VPB/h plus > or =4 couplets/d (OR 2.3) or > or =10 VPB/h plus > or =1 nsusVT/d (OR 2.8). CONCLUSION: Non-sustained VTs are only associated with poor prognosis if combined with frequent VPBs. |
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