Electrophysiologic Testing to Identify High-Risk Patients After Acute Myocardial Infarction
Many patients who survive the acute phase of a myocardial infarction are at risk of sudden cardiac death after hospital discharge, often in the first six months after leaving the hospital. Some factors that indicate high frequency of sudden death include substantial ventricular myocardial dysfunction  and the occurrence of “complex” premature ventricular depolarizations and nonsustained ventricular tachycardia [2–4]. However, the predictive value of these factors alone for sudden death is not sufficiently accurate for clinical usefulness. In patients who have coronary artery disease but no recent myocardial infarction, electrophysiologic stimulation has a high degree of sensitivity  for inducing the patient’s clinical arrhythmia, and serial electrophysiologic testing has proven useful for determining the drug therapy that will prevent recurrent arrhythmias [5–8]. Recently, electrophysiologic testing to initiate ventricular tachycardia has been advocated as a technique to identify patients in the postmyocardial infarction period most likely to have sudden cardiac death [9, 10].
KeywordsCatheter Expense Cardiol Hunt Dura
Unable to display preview. Download preview PDF.
- 5.Naccarelli GV, Prystowsky EN, Jackman WM, Heger JJ, Rahilly GT, Zipes DP: Role of electrophysiologic testing in managing patients who have ventricular tachycardia unrelated to coronary artery disease. Am J Cardiol 50: l65, 1982.Google Scholar
- 15.Marchlinski EE, Waxman HL, Buxton AE, Josephson ME: Predictive value of programmed stimulation in determining electrical instability after myocardial infarction. J Am Coll Cardiol 1: 585, 1983.Google Scholar
- 17.Denniss AR, Cody DV, Fenton SM, Richards DA, Ross DL, Russell PA, Young AA, Uther JB: Significance of delayed activation potentials in survivors of myocardial infarction. J Am Coll Cardiol 1: 582, 1983.Google Scholar
- 19.Lie KI, Liem KL, Schuilenburg RM, David GK, Durrer D: Early identification of patients developing late in-hospital ventricular fibrillation after discharge from the coronary care unit: a 5 1/2 year retrospective and prospective study of 1,897 patients. Am J Cardiol 41: 674, 1978.PubMedCrossRefGoogle Scholar