PMID- 18180022
OWN - NLM
STAT- MEDLINE
DCOM- 20080507
LR  - 20161222
IS  - 1547-5271 (Print)
IS  - 1547-5271 (Linking)
VI  - 5
IP  - 1
DP  - 2008 Jan
TI  - Electrocardiographic factors playing a role in ischemic ventricular fibrillation 
      in ST elevation myocardial infarction are related to the culprit artery.
PG  - 71-8
LID - 10.1016/j.hrthm.2007.09.011 [doi]
AB  - BACKGROUND: Sudden cardiac death caused by ischemic ventricular fibrillation (VF) 
      associated with ST elevation myocardial infarction (STEMI) is one of the most 
      frequent causes of death. OBJECTIVE: We hypothesized that electrocardiographic 
      (ECG) characteristics differ between STEMI patients with and without ischemic VF. 
      METHODS: Fifty-five first STEMI patients with at least one 12-lead ECG recorded 
      before ischemic VF were compared with 110 first STEMI patients without ischemic 
      VF. Patients with bundle branch blocks or high-degree atrioventricular blocks 
      with escape rhythms were not included. ECG measurements were performed manually 
      after scanning the ECG with the most prominent ST deviation into a software 
      environment and magnifying it 4 times. RESULTS: Mean age was 57 +/- 12 years, and 
      126 patients were male. No differences were present between the VF and control 
      group regarding baseline, enzymatic, and angiographic data. In left circumflex 
      artery and right coronary artery myocardial infarction, a longer QRS interval 
      (109 +/- 23 ms vs. 91 +/- 16 ms, P = .02 and 107 +/- 24 ms vs. 93 +/- 19, P = 
      .02) was present. In the latter the PR interval (211 +/- 64 ms vs. 160 +/- 36 ms, 
      P <.001) and ST deviation score (3.6 +/- 1.0 mV vs. 1.7 +/- 1.5 mV, P <.001) were 
      also increased. In the left anterior descending artery group no differences in 
      conduction intervals and ST deviation score were present. CONCLUSION: Longer PR 
      and QRS intervals in right coronary artery and left circumflex artery MI fit with 
      the perfusion and activation pattern of the atrioventricular node and the 
      ventricular myocardium. Myocardium perfused by the left anterior descending 
      artery is activated earliest, hiding any intraventricular conduction delay within 
      the QRS complex. Intramural slowed conduction could be a substrate for ischemic 
      VF.
FAU - Lemmert, Miguel E
AU  - Lemmert ME
AD  - Department of Cardiology, University Hospital Maastricht, Maastricht, The 
      Netherlands. m.lemmert@cardio.azm.nl
FAU - de Jong, Jonas S S G
AU  - de Jong JS
FAU - van Stipdonk, Antonius M W
AU  - van Stipdonk AM
FAU - Crijns, Harry J G M
AU  - Crijns HJ
FAU - Wellens, Hein J J
AU  - Wellens HJ
FAU - Krucoff, Mitchell W
AU  - Krucoff MW
FAU - Dekker, Lukas R
AU  - Dekker LR
FAU - Wilde, Arthur A M
AU  - Wilde AA
FAU - Gorgels, Anton P M
AU  - Gorgels AP
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20070919
PL  - United States
TA  - Heart Rhythm
JT  - Heart rhythm
JID - 101200317
SB  - IM
EIN - Heart Rhythm. 2008 May;5(5):773
MH  - Case-Control Studies
MH  - Coronary Vessels/*pathology/physiopathology
MH  - *Electrocardiography
MH  - Heart Conduction System/*physiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*physiopathology
MH  - Myocardial Ischemia/*complications/physiopathology
MH  - Retrospective Studies
MH  - Tachycardia/physiopathology
MH  - Ventricular Fibrillation/*etiology/physiopathology
EDAT- 2008/01/09 09:00
MHDA- 2008/05/08 09:00
CRDT- 2008/01/09 09:00
PHST- 2007/06/21 00:00 [received]
PHST- 2007/09/12 00:00 [accepted]
PHST- 2008/01/09 09:00 [pubmed]
PHST- 2008/05/08 09:00 [medline]
PHST- 2008/01/09 09:00 [entrez]
AID - S1547-5271(07)00932-0 [pii]
AID - 10.1016/j.hrthm.2007.09.011 [doi]
PST - ppublish
SO  - Heart Rhythm. 2008 Jan;5(1):71-8. doi: 10.1016/j.hrthm.2007.09.011. Epub 2007 Sep 
      19.