Early Repolarization Increases the Occurrence of Sustained Ventricular Tachyarrhythmias and Sudden Death in the Chronic Phase of an Acute Myocardial Infarction
BACKGROUND—We recently showed that the presence of early repolarization (ER) increases the risk of ventricular fibrillation occurrences in the early phase of acute myocardial infarction (AMI). This study aimed to clarify whether an association exists between ER and occurrences of ventricular tachyar...
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| Veröffentlicht in: | Circulation. Arrhythmia and electrophysiology 2014-08, Vol.7 (4), p.626-632 |
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| creator | Naruse, Yoshihisa Tada, Hiroshi Harimura, Yoshie Ishibashi, Mayu Noguchi, Yuichi Sato, Akira Hoshi, Tomoya Sekiguchi, Yukio Aonuma, Kazutaka |
| description | BACKGROUND—We recently showed that the presence of early repolarization (ER) increases the risk of ventricular fibrillation occurrences in the early phase of acute myocardial infarction (AMI). This study aimed to clarify whether an association exists between ER and occurrences of ventricular tachyarrhythmias or sudden death in the chronic phase of AMI.
METHODS AND RESULTS—This study retrospectively enrolled 1131 patients (67±12 years; 862 men) with AMIs surviving 14 days post-AMI. The primary end point was the occurrence of sustained ventricular tachyarrhythmias or sudden death >14 days after the AMI onset. We evaluated the presence of ER from the predischarge ECG (mean 10±3 days post-AMI). ER was defined as an elevation of the terminal portion of the QRS complex of >0.1 mV in inferior or lateral leads. After a median follow-up of 26.2 months, 26 patients had an episode of ventricular tachyarrhythmias or sudden death. A multivariable Cox regression analysis revealed the presence of ER (hazard ratio, 5.37; 95% confidence interval, 2.27–12.69; PI (hazard ratio, 2.75; 95% confidence interval, 1.24–6.07; P=0.013), and a left ventricular ejection fraction of |
| doi_str_mv | 10.1161/CIRCEP.113.000939 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1555247690</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1555247690</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4569-e7675bd3b6993ca5445b6051fd331bd5edf116757f0f598c13377eb055d9a7b33</originalsourceid><addsrcrecordid>eNp9kcFu1DAURSMEoqXwAWyQl2ym2HXsxMsqDDBSUatS2EYv9ots8DiD7agKP8Ov4iEtS1a-i3OPLd-qes3oOWOSvet2t932pmR-TilVXD2pTpmq2YbTtn76mFmtTqoXKX2nVLKWyefVyUXdSl634rT6vYXoF3KLh8lDdL8guymQXdARIWEi2SK51nqOEYNGMo3ky5wyuICGfMOQo9NzKZI70HaBGO2S7d5BIhBMQY3BQN4jZEtc-CvrbJyC0-TGFv_RB4Fc6jkj-bxMGqJx4Mv9I0R9fMrL6tkIPuGrh_Os-vphe9d92lxdf9x1l1cbXQupNtjIRgyGD1IprkHUtRgkFWw0nLPBCDRj-bFGNCMdhWo147xpcKBCGAXNwPlZ9Xb1HuL0c8aU-71LGr2HgNOceiaEuKgbqWhB2YrqOKUUcewP0e0hLj2j_XGXft2lZN6vu5TOmwf9POzR_Gs8DlEAsQL3k88Y0w8_32PsLYLP9j_iP6StnFg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1555247690</pqid></control><display><type>article</type><title>Early Repolarization Increases the Occurrence of Sustained Ventricular Tachyarrhythmias and Sudden Death in the Chronic Phase of an Acute Myocardial Infarction</title><source>MEDLINE</source><source>American Heart Association Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Naruse, Yoshihisa ; Tada, Hiroshi ; Harimura, Yoshie ; Ishibashi, Mayu ; Noguchi, Yuichi ; Sato, Akira ; Hoshi, Tomoya ; Sekiguchi, Yukio ; Aonuma, Kazutaka</creator><creatorcontrib>Naruse, Yoshihisa ; Tada, Hiroshi ; Harimura, Yoshie ; Ishibashi, Mayu ; Noguchi, Yuichi ; Sato, Akira ; Hoshi, Tomoya ; Sekiguchi, Yukio ; Aonuma, Kazutaka</creatorcontrib><description>BACKGROUND—We recently showed that the presence of early repolarization (ER) increases the risk of ventricular fibrillation occurrences in the early phase of acute myocardial infarction (AMI). This study aimed to clarify whether an association exists between ER and occurrences of ventricular tachyarrhythmias or sudden death in the chronic phase of AMI.
METHODS AND RESULTS—This study retrospectively enrolled 1131 patients (67±12 years; 862 men) with AMIs surviving 14 days post-AMI. The primary end point was the occurrence of sustained ventricular tachyarrhythmias or sudden death >14 days after the AMI onset. We evaluated the presence of ER from the predischarge ECG (mean 10±3 days post-AMI). ER was defined as an elevation of the terminal portion of the QRS complex of >0.1 mV in inferior or lateral leads. After a median follow-up of 26.2 months, 26 patients had an episode of ventricular tachyarrhythmias or sudden death. A multivariable Cox regression analysis revealed the presence of ER (hazard ratio, 5.37; 95% confidence interval, 2.27–12.69; P<0.001), Killip class on admission of >I (hazard ratio, 2.75; 95% confidence interval, 1.24–6.07; P=0.013), and a left ventricular ejection fraction of <35% (hazard ratio, 11.83; 95% confidence interval, 5.16–27.13; P<0.001) were significantly associated with event occurrences. As features of the ER pattern, ER in the inferior leads, high-amplitude ER, a notched morphology, and ER without ST-segment elevation were associated with an increased risk of event occurrences.
CONCLUSIONS—ER observed at a mean of 10 days post-AMI may be a marker for a subsequent risk of ventricular tachyarrhythmias or sudden death.</description><identifier>ISSN: 1941-3149</identifier><identifier>EISSN: 1941-3084</identifier><identifier>DOI: 10.1161/CIRCEP.113.000939</identifier><identifier>PMID: 24863485</identifier><language>eng</language><publisher>United States: American Heart Association, Inc</publisher><subject>Action Potentials ; Aged ; Chi-Square Distribution ; Death, Sudden, Cardiac - etiology ; Electrocardiography ; Female ; Heart Conduction System - physiopathology ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction - complications ; Myocardial Infarction - diagnosis ; Myocardial Infarction - mortality ; Myocardial Infarction - physiopathology ; Predictive Value of Tests ; Proportional Hazards Models ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Stroke Volume ; Tachycardia, Ventricular - diagnosis ; Tachycardia, Ventricular - etiology ; Tachycardia, Ventricular - mortality ; Tachycardia, Ventricular - physiopathology ; Time Factors ; Ventricular Function, Left</subject><ispartof>Circulation. Arrhythmia and electrophysiology, 2014-08, Vol.7 (4), p.626-632</ispartof><rights>2014 American Heart Association, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4569-e7675bd3b6993ca5445b6051fd331bd5edf116757f0f598c13377eb055d9a7b33</citedby><cites>FETCH-LOGICAL-c4569-e7675bd3b6993ca5445b6051fd331bd5edf116757f0f598c13377eb055d9a7b33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,3674,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24863485$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Naruse, Yoshihisa</creatorcontrib><creatorcontrib>Tada, Hiroshi</creatorcontrib><creatorcontrib>Harimura, Yoshie</creatorcontrib><creatorcontrib>Ishibashi, Mayu</creatorcontrib><creatorcontrib>Noguchi, Yuichi</creatorcontrib><creatorcontrib>Sato, Akira</creatorcontrib><creatorcontrib>Hoshi, Tomoya</creatorcontrib><creatorcontrib>Sekiguchi, Yukio</creatorcontrib><creatorcontrib>Aonuma, Kazutaka</creatorcontrib><title>Early Repolarization Increases the Occurrence of Sustained Ventricular Tachyarrhythmias and Sudden Death in the Chronic Phase of an Acute Myocardial Infarction</title><title>Circulation. Arrhythmia and electrophysiology</title><addtitle>Circ Arrhythm Electrophysiol</addtitle><description>BACKGROUND—We recently showed that the presence of early repolarization (ER) increases the risk of ventricular fibrillation occurrences in the early phase of acute myocardial infarction (AMI). This study aimed to clarify whether an association exists between ER and occurrences of ventricular tachyarrhythmias or sudden death in the chronic phase of AMI.
METHODS AND RESULTS—This study retrospectively enrolled 1131 patients (67±12 years; 862 men) with AMIs surviving 14 days post-AMI. The primary end point was the occurrence of sustained ventricular tachyarrhythmias or sudden death >14 days after the AMI onset. We evaluated the presence of ER from the predischarge ECG (mean 10±3 days post-AMI). ER was defined as an elevation of the terminal portion of the QRS complex of >0.1 mV in inferior or lateral leads. After a median follow-up of 26.2 months, 26 patients had an episode of ventricular tachyarrhythmias or sudden death. A multivariable Cox regression analysis revealed the presence of ER (hazard ratio, 5.37; 95% confidence interval, 2.27–12.69; P<0.001), Killip class on admission of >I (hazard ratio, 2.75; 95% confidence interval, 1.24–6.07; P=0.013), and a left ventricular ejection fraction of <35% (hazard ratio, 11.83; 95% confidence interval, 5.16–27.13; P<0.001) were significantly associated with event occurrences. As features of the ER pattern, ER in the inferior leads, high-amplitude ER, a notched morphology, and ER without ST-segment elevation were associated with an increased risk of event occurrences.
CONCLUSIONS—ER observed at a mean of 10 days post-AMI may be a marker for a subsequent risk of ventricular tachyarrhythmias or sudden death.</description><subject>Action Potentials</subject><subject>Aged</subject><subject>Chi-Square Distribution</subject><subject>Death, Sudden, Cardiac - etiology</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Heart Conduction System - physiopathology</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Myocardial Infarction - complications</subject><subject>Myocardial Infarction - diagnosis</subject><subject>Myocardial Infarction - mortality</subject><subject>Myocardial Infarction - physiopathology</subject><subject>Predictive Value of Tests</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Stroke Volume</subject><subject>Tachycardia, Ventricular - diagnosis</subject><subject>Tachycardia, Ventricular - etiology</subject><subject>Tachycardia, Ventricular - mortality</subject><subject>Tachycardia, Ventricular - physiopathology</subject><subject>Time Factors</subject><subject>Ventricular Function, Left</subject><issn>1941-3149</issn><issn>1941-3084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFu1DAURSMEoqXwAWyQl2ym2HXsxMsqDDBSUatS2EYv9ots8DiD7agKP8Ov4iEtS1a-i3OPLd-qes3oOWOSvet2t932pmR-TilVXD2pTpmq2YbTtn76mFmtTqoXKX2nVLKWyefVyUXdSl634rT6vYXoF3KLh8lDdL8guymQXdARIWEi2SK51nqOEYNGMo3ky5wyuICGfMOQo9NzKZI70HaBGO2S7d5BIhBMQY3BQN4jZEtc-CvrbJyC0-TGFv_RB4Fc6jkj-bxMGqJx4Mv9I0R9fMrL6tkIPuGrh_Os-vphe9d92lxdf9x1l1cbXQupNtjIRgyGD1IprkHUtRgkFWw0nLPBCDRj-bFGNCMdhWo147xpcKBCGAXNwPlZ9Xb1HuL0c8aU-71LGr2HgNOceiaEuKgbqWhB2YrqOKUUcewP0e0hLj2j_XGXft2lZN6vu5TOmwf9POzR_Gs8DlEAsQL3k88Y0w8_32PsLYLP9j_iP6StnFg</recordid><startdate>201408</startdate><enddate>201408</enddate><creator>Naruse, Yoshihisa</creator><creator>Tada, Hiroshi</creator><creator>Harimura, Yoshie</creator><creator>Ishibashi, Mayu</creator><creator>Noguchi, Yuichi</creator><creator>Sato, Akira</creator><creator>Hoshi, Tomoya</creator><creator>Sekiguchi, Yukio</creator><creator>Aonuma, Kazutaka</creator><general>American Heart Association, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201408</creationdate><title>Early Repolarization Increases the Occurrence of Sustained Ventricular Tachyarrhythmias and Sudden Death in the Chronic Phase of an Acute Myocardial Infarction</title><author>Naruse, Yoshihisa ; Tada, Hiroshi ; Harimura, Yoshie ; Ishibashi, Mayu ; Noguchi, Yuichi ; Sato, Akira ; Hoshi, Tomoya ; Sekiguchi, Yukio ; Aonuma, Kazutaka</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4569-e7675bd3b6993ca5445b6051fd331bd5edf116757f0f598c13377eb055d9a7b33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Action Potentials</topic><topic>Aged</topic><topic>Chi-Square Distribution</topic><topic>Death, Sudden, Cardiac - etiology</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Heart Conduction System - physiopathology</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Myocardial Infarction - complications</topic><topic>Myocardial Infarction - diagnosis</topic><topic>Myocardial Infarction - mortality</topic><topic>Myocardial Infarction - physiopathology</topic><topic>Predictive Value of Tests</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Stroke Volume</topic><topic>Tachycardia, Ventricular - diagnosis</topic><topic>Tachycardia, Ventricular - etiology</topic><topic>Tachycardia, Ventricular - mortality</topic><topic>Tachycardia, Ventricular - physiopathology</topic><topic>Time Factors</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Naruse, Yoshihisa</creatorcontrib><creatorcontrib>Tada, Hiroshi</creatorcontrib><creatorcontrib>Harimura, Yoshie</creatorcontrib><creatorcontrib>Ishibashi, Mayu</creatorcontrib><creatorcontrib>Noguchi, Yuichi</creatorcontrib><creatorcontrib>Sato, Akira</creatorcontrib><creatorcontrib>Hoshi, Tomoya</creatorcontrib><creatorcontrib>Sekiguchi, Yukio</creatorcontrib><creatorcontrib>Aonuma, Kazutaka</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation. Arrhythmia and electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Naruse, Yoshihisa</au><au>Tada, Hiroshi</au><au>Harimura, Yoshie</au><au>Ishibashi, Mayu</au><au>Noguchi, Yuichi</au><au>Sato, Akira</au><au>Hoshi, Tomoya</au><au>Sekiguchi, Yukio</au><au>Aonuma, Kazutaka</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early Repolarization Increases the Occurrence of Sustained Ventricular Tachyarrhythmias and Sudden Death in the Chronic Phase of an Acute Myocardial Infarction</atitle><jtitle>Circulation. Arrhythmia and electrophysiology</jtitle><addtitle>Circ Arrhythm Electrophysiol</addtitle><date>2014-08</date><risdate>2014</risdate><volume>7</volume><issue>4</issue><spage>626</spage><epage>632</epage><pages>626-632</pages><issn>1941-3149</issn><eissn>1941-3084</eissn><abstract>BACKGROUND—We recently showed that the presence of early repolarization (ER) increases the risk of ventricular fibrillation occurrences in the early phase of acute myocardial infarction (AMI). This study aimed to clarify whether an association exists between ER and occurrences of ventricular tachyarrhythmias or sudden death in the chronic phase of AMI.
METHODS AND RESULTS—This study retrospectively enrolled 1131 patients (67±12 years; 862 men) with AMIs surviving 14 days post-AMI. The primary end point was the occurrence of sustained ventricular tachyarrhythmias or sudden death >14 days after the AMI onset. We evaluated the presence of ER from the predischarge ECG (mean 10±3 days post-AMI). ER was defined as an elevation of the terminal portion of the QRS complex of >0.1 mV in inferior or lateral leads. After a median follow-up of 26.2 months, 26 patients had an episode of ventricular tachyarrhythmias or sudden death. A multivariable Cox regression analysis revealed the presence of ER (hazard ratio, 5.37; 95% confidence interval, 2.27–12.69; P<0.001), Killip class on admission of >I (hazard ratio, 2.75; 95% confidence interval, 1.24–6.07; P=0.013), and a left ventricular ejection fraction of <35% (hazard ratio, 11.83; 95% confidence interval, 5.16–27.13; P<0.001) were significantly associated with event occurrences. As features of the ER pattern, ER in the inferior leads, high-amplitude ER, a notched morphology, and ER without ST-segment elevation were associated with an increased risk of event occurrences.
CONCLUSIONS—ER observed at a mean of 10 days post-AMI may be a marker for a subsequent risk of ventricular tachyarrhythmias or sudden death.</abstract><cop>United States</cop><pub>American Heart Association, Inc</pub><pmid>24863485</pmid><doi>10.1161/CIRCEP.113.000939</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Circulation. Arrhythmia and electrophysiology, 2014-08, Vol.7 (4), p.626-632 |
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| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Action Potentials Aged Chi-Square Distribution Death, Sudden, Cardiac - etiology Electrocardiography Female Heart Conduction System - physiopathology Humans Kaplan-Meier Estimate Male Middle Aged Multivariate Analysis Myocardial Infarction - complications Myocardial Infarction - diagnosis Myocardial Infarction - mortality Myocardial Infarction - physiopathology Predictive Value of Tests Proportional Hazards Models Retrospective Studies Risk Assessment Risk Factors Stroke Volume Tachycardia, Ventricular - diagnosis Tachycardia, Ventricular - etiology Tachycardia, Ventricular - mortality Tachycardia, Ventricular - physiopathology Time Factors Ventricular Function, Left |
| title | Early Repolarization Increases the Occurrence of Sustained Ventricular Tachyarrhythmias and Sudden Death in the Chronic Phase of an Acute Myocardial Infarction |
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