What Is The Prognostic Value of Non-Sustained Ventricular Tachycardia in Patients Without Severely Depressed Ejection Fraction After Myocardial Infarction?
Complex Ventricular Ectopy (CVE)/Non-Sustained Ventricular Tachycardia (NS-VT) in the Post-Myocardial Infarction (Ml) Period: Background The predictive accuracy of CVE/NS-VT for serious arrhythmic events/sudden cardiac death (SCD) in the post-MI period has undergone radical evaluation in the last 2 decades. In 1981, Bigger et al reported on 430 patients who sustained acute MI and underwent a 24-hour Holter electrocardiogram (ECG) prior to hospital discharge . Fifty patients (11.6%) had NS-VT, in the form of ≥3 ventricular premature complexes. This group of patients had 38% 1-year mortality rate, compared with a rate of 11.6% in the group without NS-VT. NS-VT had a significant association with many other post-MI risk factors. However, VT was still significantly related to mortality when other variables, including left ventricular ejection fraction (LVEF) were controlled statistically using a multiple logistic regression model. Similar conclusions were later published by Bigger et al. from 820 patients in the Multicenter Post-Infarction Program, of whom 11% had NS-VT recorded on Holter ECG 11±3 days post-MI . NS-VT had a strong and statistically significant association with all-cause and arrhythmic mortality, independent of other risk stratifiers, including depressed LVEF.
KeywordsHeart Rate Variability Left Ventricular Ejection Fraction Sudden Cardiac Death Preserve Left Ventricular Ejection Fraction Postmyocardial Infarction
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