PMID- 21129504
OWN - NLM
STAT- MEDLINE
DCOM- 20110809
LR  - 20161222
IS  - 1556-3871 (Electronic)
IS  - 1547-5271 (Linking)
VI  - 8
IP  - 4
DP  - 2011 Apr
TI  - Effect of reperfusion time on inducible ventricular tachycardia early and 
      spontaneous ventricular arrhythmias late after ST elevation myocardial infarction 
      treated with primary percutaneous coronary intervention.
PG  - 493-9
LID - 10.1016/j.hrthm.2010.11.046 [doi]
AB  - BACKGROUND: Prompt thrombolytic reperfusion reduces postinfarct ventricular 
      electrical instability after ST elevation myocardial infarction (STEMI). 
      OBJECTIVE: The purpose of this study was to examine the relationship between 
      reperfusion time and inducible ventricular tachycardia (VT) early and spontaneous 
      ventricular arrhythmias (VAs) late after primary percutaneous coronary 
      intervention (PCI) for STEMI. METHODS: Consecutive patients were recruited if 
      they (1) had no prior coronary disease, (2) had been reperfused with primary PCI, 
      (3) had postinfarct ejection fraction </=40%, and (4) had undergone cardiac 
      electrophysiologic study (n = 128). Three groups were compared according to 
      reperfusion time: early (</=3 hours, n = 26), intermediate (>3-5 hours, n = 45), or 
      delayed reperfusion (>5 hours, n = 57). Spontaneous VA was a composite endpoint 
      of sudden death or defibrillator-treated VA. RESULTS: Mean ejection fraction (33% 
      +/- 5%, 31% +/- 6%, and 31% +/- 7%, P = .41) and peak creatinine kinase (P = .37) were 
      similar between groups. VT was inducible in 11.5%, 17.8%, and 36.8% of patients 
      in the early, intermediate, and delayed reperfusion groups, respectively (P = 
      .003). At 2 years, the incidence of spontaneous VA was 0%, 8.9%, and 14% in the 
      early, intermediate, and delayed reperfusion groups, respectively (P = .025). By 
      multivariable analysis, delayed reperfusion conferred a sixfold increase in the 
      odds of inducible VT (P = .01). Although inducible VT was the strongest predictor 
      of spontaneous VA (hazard ratio 14.31, P = .001), delayed reperfusion conferred a 
      threefold increase in risk when inducible VT was excluded from the multivariable 
      model (P = .035). CONCLUSION: Reperfusion time is a critical determinant of 
      postinfarct ventricular electrical instability early and late after STEMI treated 
      with primary PCI.
CI  - Crown Copyright (c) 2011. Published by Elsevier Inc. All rights reserved.
FAU - Kumar, Saurabh
AU  - Kumar S
AD  - Department of Cardiology, Westmead Hospital, New South Wales, Australia.
FAU - Sivagangabalan, Gopal
AU  - Sivagangabalan G
FAU - Thiagalingam, Aravinda
AU  - Thiagalingam A
FAU - West, Elizabeth B
AU  - West EB
FAU - Narayan, Arun
AU  - Narayan A
FAU - Sadick, Norman
AU  - Sadick N
FAU - Ong, Andrew T L
AU  - Ong AT
FAU - Kovoor, Pramesh
AU  - Kovoor P
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20101130
PL  - United States
TA  - Heart Rhythm
JT  - Heart rhythm
JID - 101200317
SB  - IM
EIN - Heart Rhythm. 2011 Jun;8(6):953
CIN - Heart Rhythm. 2011 Apr;8(4):500-2. PMID: 21220047
MH  - Angioplasty, Balloon, Coronary/*adverse effects
MH  - *Electrocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/physiopathology/*therapy
MH  - Myocardial Reperfusion/*methods
MH  - Tachycardia, Ventricular/etiology/physiopathology/*surgery
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2010/12/07 06:00
MHDA- 2011/08/10 06:00
CRDT- 2010/12/07 06:00
PHST- 2010/10/17 00:00 [received]
PHST- 2010/11/27 00:00 [accepted]
PHST- 2010/12/07 06:00 [entrez]
PHST- 2010/12/07 06:00 [pubmed]
PHST- 2011/08/10 06:00 [medline]
AID - S1547-5271(10)01308-1 [pii]
AID - 10.1016/j.hrthm.2010.11.046 [doi]
PST - ppublish
SO  - Heart Rhythm. 2011 Apr;8(4):493-9. doi: 10.1016/j.hrthm.2010.11.046. Epub 2010 
      Nov 30.