Prevalence of ventricular arrhythmias during silent myocardial ischemia

  • M. Zehender
  • T. Meinertz
  • A. Geibel
  • S. Hohnloser
  • C. Weiss
  • U. Koscheck
  • H. Just
Conference paper

Abstract

Symptomatic ST depression at rest and during exercise, as well as the occurrence of ventricular arrhythmias, are known to be independent risk factors in patients with coronary artery disease (1–4). However, the interaction of ischemia and ventricular arrhythmias is frequently difficult to analyze. In patients with coronary artery disease an exercise induced ST depression can secondarily induce ventricular arrhythmias originating in the ischemic or peri-ischemic myocardium, as well as persistent ventricular arrhythmias that can cause ischemic changes in the myocardium. Theroux et al. reported on patients after myocardial infarction a 1-year mortality rate of 16% versus 1% whether or not ST-segment depressions were present and of 11% versus 4% whether or not exercise-nduced ventricular arrhythmias were present (1). Udall and Ellestad reported that death due to cardiac causes over a 5-year period occurred in 8% of patients with exercise-induced ventricular arrhythmias and a normal ST-segment response, in contrast to 1.4% of patients with no ventricular arrhythmia and a normal ST-segment response. However, in 22% of patients with exercise-induced ventricular arrhythmias and an abnormal ST-segment response, sudden death was present in the 5 year follow-up (2). Ruberman et al. showed that there is a higher probability of dying from a cardiac event when patients are older, have had previous myocardial infarction and exercise induced ST-segment depression or ventricular arrhythmias (3). The risk further increases when the risk factors are present in combination.

Keywords

Depression Ischemia Fibril Cardiol Nifedipine 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1987

Authors and Affiliations

  • M. Zehender
    • 1
    • 2
  • T. Meinertz
    • 1
  • A. Geibel
    • 1
  • S. Hohnloser
    • 1
  • C. Weiss
    • 1
  • U. Koscheck
    • 1
  • H. Just
    • 1
  1. 1.Innere Medizin IIIUniversitätsklinik FreiburgGermany
  2. 2.Innere Medizin IIIFreiburgGermany

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