Continuous electrocardiographic monitoring for more than one hour does not improve the prognostic value of ventricular arrhythmias in survivors of first acute myocardial infarction (original) (raw)
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Journal of the American College of Cardiology, 1989
A prospective study was undertaken of the prognostic significance of quantitative signal-averaged electrocardiographic (ECG) variables relative to clinical variables, site of myocardial infarction, left ventricular ejection fraction and characteristics of ventricular premature beats in 115 patients (mean age 62 2 12 years) studied 10 f 6 days after myocardial infarction. Signal-averaged variables included the root mean square voltage of the terminal 40 ms, the duration of the filtered signal-averaged QRS complex and low amplitude signals <40 PV determined at 25 and 40 Hz high pass filtering in all patients. Of the 115 patients, 51 (44%) had an abnormal signalaveraged ECG (one or more abnormal signal-averaged variables), 51 (44%) at 25 Hz and 48 (42%) at 40 Hz high pass filtering. A higher proportion of patients with an inferior wall infarction had an abnormal signal-averaged ECG as compared with patients with anterior wall infarction (58% versus 31%). Over a 14 + 8 month follow-up period 16 patients (14%) had an arrhythmic event. An abnormal signal-averaged ECG at 40 Hz high pass filtering had a higher sensitivity (81% versus 75%) and specificity (65% versus 61%) than at 25 Hz high pass filtering. The predictive value of the signal-averaged ECG was superior to that of the ejection Ventricular tachycardia and ventricular fibrillation are the major causes of sudden cardiac death after myocardial infarction. Although the ultimate factors that result in a From the Clinical Electrophysiology and Electrocardiography Section,
Prognostic Value of a Normal or Nonspecific Initial Electrocardiogram in Acute Myocardial Infarction
2006
Results In-hospital mortality rates were 5.7%, 8.7%, and 11.5% while the rates of the composite of mortality and life-threatening adverse events were 19.2%, 27.5%, and 34.9% for the normal, nonspecific, and diagnostic ECG groups, respectively. Af- ter adjusting for other predictor variables, the odds of mortality for the normal ECG group was 0.59 (95% confidence interval (CI), 0.56-0.63; P.001) and
Heart, 1988
The incidence and time course of complex ventricular arrhythmias and of the abnormal signal averaged electrocardiogram were studied prospectively in 90 patients in the first two months after acute myocardial infarction. Serial recordings ofboth 24 hour ambulatory and signal averaged electrocardiograms were obtained 0-5 days (phase 1), 6-30 days (phase 2), and 31-60 days (phase 3) after infarction. A total of 264 ambulatory electrocardiograms and 264 signal averaged electrocardiograms were available for analysis. Complex ventricular arrhythmias were seen in 31%, 17%0, and 38% of patients during phases 1, 2, and 3 respectively, and abnormal signal averaged electrocardiogram in 13%0024%0, and 16%. The incidence of complex ventricular arrhythmias was