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A Journal on Internal Medicine

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Panminerva Medica 2000 March;42(1):1-5

language: English

Electrophysiological instability in the acute phase: Prognostic significance of early ventricular fibrillation in acute myocardial infarction

Martinelli M. M., Danesi A., Greco G., Carunchio A., Pandolfo L., Ceci V.

From the Department of Cardiology Santo Spirito Hospital, Rome, Italy


Background. In the prog­nostic strat­ifi­ca­tion of ­patients ­affected by AMI is impor­tant to eval­uate, ­besides the assess­ment of ­left ven­tric­ular func­tion and ­residual ­ischemia, the pres­ence of elec­tro­phys­io­log­ical ­instability.
Methods. We ­have ana­lysed 15 ­patients all ­affected by AMI com­pli­cated by ­early ven­tric­ular fib­ril­la­tion. During the hos­pital ­phase we eval­u­ated the E.F.% (­ECHO) and the pres­ence of ­late ven­tric­ular poten­tials (­SAECG). After hos­pital dis­charge we fol­lowed up the ­patients for 6 ­months.
Results. None of the ­patients ­died ­during the hos­pital ­phase ­while the post­hos­pital car­diac mor­tality was 20%. The three ­patients ­dead ­during the ­follow-up had an AMI local­ized in the ante­ro­lat­eral ­wall of the ­left ven­tricle, an E.F.% ­less ­than 40% and LVP pos­i­tive in the hos­pital ­phase. Besides the clin­ical ­course was com­pli­cated by car­diac ­failure.
Conclusions. We con­clude ­that ­these three ­patients are a “­high ­risk pro­file sub­group” and ­should be sub­mitted to exten­sive eval­u­a­tion ­with car­diac cath­et­er­iza­tion, cor­o­nary arter­i­og­raphy and pro­grammed ven­tric­ular stim­u­la­tion.

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