PMID- 19939739
OWN - NLM
STAT- MEDLINE
DCOM- 20110322
LR  - 20161222
IS  - 1556-3871 (Electronic)
IS  - 1547-5271 (Linking)
VI  - 7
IP  - 1
DP  - 2010 Jan
TI  - RR-interval irregularity precedes ventricular fibrillation in ST elevation acute 
      myocardial infarction.
PG  - 65-71
LID - 10.1016/j.hrthm.2009.09.024 [doi]
AB  - BACKGROUND: Sudden cardiac arrest is a leading cause of death in industrialized 
      countries, and ischemic ventricular fibrillation (VF) is a frequent cause. 
      OBJECTIVE: The purpose of this study was to determine whether patients with ST 
      elevation myocardial infarction (STEMI) who develop ischemic VF show more overall 
      RR-interval irregularity (RRI) than do STEMI patients without ischemic VF. 
      METHODS: Ischemic VF was identified in 41 patients from 1,473 digital 12-lead 
      Holter recordings from three separate STEMI studies. Continuous 3-lead and 
      12-lead electrocardiogram (ECG) snapshots recorded every minute were compared 
      between all ischemic VF patients and 123 random patients without ischemic VF. 
      Time intervals from start of Holter to ischemic VF and equivalent intervals in 
      the controls were used for calculations. ECG variables related to conduction 
      intervals and severity of ischemia were measured using the most ischemic 12-lead 
      ECG. RRI was calculated as the square root of the mean squared differences of 
      successive RR intervals. For RRI, all QRS complexes, including ventricular 
      ectopic beats, were used. RESULTS: No baseline differences were observed between 
      the study and control groups, except for male preponderance among ischemic VF 
      patients (90% vs 72%, P = .019). QRS interval, ECG ischemia severity, RRI, and 
      number of ventricular ectopic beats were significantly associated with ischemic 
      VF. Multivariate analysis revealed RRI (odds ratio 1.006, 95% confidence interval 
      1.001-1.010, P = .016) and ST deviation score (odds ratio 1.073, 95% confidence 
      interval 1.041-1.106, P <.001) as the only statistically significant predictors 
      of ischemic VF. CONCLUSION: In the period before ischemic VF, RRI and ST 
      deviation score are associated with ischemic VF in STEMI patients. These findings 
      could have important pathophysiologic and clinical implications.
FAU - Lemmert, Miguel E
AU  - Lemmert ME
AD  - Department of Cardiology, Maastricht University Medical Center, Maastricht, The 
      Netherlands. mlemmert@gmail.com
FAU - Majidi, Mohamed
AU  - Majidi M
FAU - Krucoff, Mitchell W
AU  - Krucoff MW
FAU - Bekkers, Sebastiaan C A M
AU  - Bekkers SC
FAU - Crijns, Harry J G M
AU  - Crijns HJ
FAU - Wellens, Hein J J
AU  - Wellens HJ
FAU - Kosinski, Andrzej S
AU  - Kosinski AS
FAU - Gorgels, Anton P M
AU  - Gorgels AP
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20090919
PL  - United States
TA  - Heart Rhythm
JT  - Heart rhythm
JID - 101200317
SB  - IM
CIN - Heart Rhythm. 2010 Jan;7(1):72-3. PMID: 20129287
MH  - Aged
MH  - Area Under Curve
MH  - Confidence Intervals
MH  - Death, Sudden, Cardiac/*etiology
MH  - Electrocardiography, Ambulatory
MH  - Female
MH  - Heart Rate
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Myocardial Infarction/complications/*physiopathology
MH  - Myocardial Ischemia/complications/*physiopathology
MH  - Odds Ratio
MH  - ROC Curve
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Ventricular Fibrillation/etiology/*physiopathology
EDAT- 2009/11/27 06:00
MHDA- 2011/03/23 06:00
CRDT- 2009/11/27 06:00
PHST- 2009/08/09 00:00 [received]
PHST- 2009/09/15 00:00 [accepted]
PHST- 2009/11/27 06:00 [entrez]
PHST- 2009/11/27 06:00 [pubmed]
PHST- 2011/03/23 06:00 [medline]
AID - S1547-5271(09)01043-1 [pii]
AID - 10.1016/j.hrthm.2009.09.024 [doi]
PST - ppublish
SO  - Heart Rhythm. 2010 Jan;7(1):65-71. doi: 10.1016/j.hrthm.2009.09.024. Epub 2009 
      Sep 19.