What Is The Prognostic Value of Non-Sustained Ventricular Tachycardia in Patients Without Severely Depressed Ejection Fraction After Myocardial Infarction?

摘要

The predictive accuracy of CVE/NS-VT for serious arrhythmic events/sudden cardiac death (SCD) in the post-Mi period has undergone radical evaluation in the last 2 decades. In 1981, Bigger et al reported on 430 patients who sustained acute MI and underwent a 24-hour Holter electrocardiogram (EGG) prior to hospital discharge [1]. Fifty patients (11.6(percent)) had NS-VT, in the form of >= 3 ventricular premature complexes. This group of patients had 38(percent) 1-year mortality rate, compared with a rate of 11.6(percent) in the group without NS-VT. NS-VT had a significant association with many other post-Mi risk factors. However, VT was still significantly related to mortality when other variables, including left ventricular ejection fraction (LVEF) were controlled statistically using a multiple logistic regression model. Similar conclusions were later published by Bigger et al. from 820 patients in the Multicenter Post-Infarction Program, of whom 11(percent) had NS-VT recorded on Holter EGG 11 (+-)3 days post-Mi [2]. NS-VT had a strong and statistically significant association with all-cause and arrhythmic mortality, independent of other risk stratifiers, including depressed LVEF.