Factors Likely to Affect the Long-term Results of Ventricular Stimulation After Myocardial Infarction

Overview

Journal Indian Pacing Electrophysiol J

Date 2010 Apr 9

PMID 20376183

Authors

Beatrice Brembilla-Perrot

Pierre Yves Zinzius

Laurent Groben

Luc Freysz

Lucian Muresan

Jerome Schwartz

Raphael P Martins

Soumaya Jarmouni

Ibrahim Nossier

Nicolas Sadoul

Hugues Blangy

Arnaud Terrier de la Chaise

Pierre Louis

Olivier Selton

Daniel Beurrier

Jean Marc Sellal

Affiliations

Soon will be listed here.

Abstract

Background: The results of programmed ventricular stimulation (PVS) may change after myocardial infarction (MI). The objective was to study the factors that could predict the results of a second PVS.

Methods: Left ventricular ejection fraction (LVEF) and QRS duration were determined and PVS performed within 3 to 14 years of one another (mean 7.5+/-5) in 50 patients studied systematically between 1 and 3 months after acute MI.

Results: QRS duration increased from 120+/-23 ms to 132+/-29 (p 0.04). LVEF did not decrease significantly (36+/-12 % vs 37+/-13 %). Ventricular tachycardia with cycle length (CL) > 220ms (VT) was induced in 11 patients at PVS 1, who had inducible VT with a CL > 220 ms (8) or < 220 ms (ventricular flutter, VFl) (3) at PVS 2. VFl or fibrillation (VF) was induced in 14 patients at PVS 1 and remained inducible in 5; 5 patients had inducible VT and 4 had a negative 2nd PVS. 2. 25 patients had initially negative PVS; 7 had secondarily inducible VT, 4 a VFl/VF, 14 a negative PVS. Changes of PVS were related to initially increasing QRS duration and secondarily changes in LVEF and revascularization but not to the number of extrastimuli required to induce VFl.

Conclusions: In patients without induced VT at first study, changes of PVS are possible during the life. Patients with initially long QRS duration and those who developed decreased LVEF are more at risk to have inducible monomorphic VT at 2nd study, than other patients.

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