Abstract
The use of thrombolytic agents is an important contributor to the improved prognosis following acute myocardial infarction observed over the last 20 years1-5. Thrombolytic agents result in modestly improved ventricular function1,5,6 although these changes are minimal and do not account for the beneficial effects of reperfusion on subsequent mortality following myocardial infarction. A mechanism by which restoration of patency of the infarct-related artery could improve survival is alteration of the electrophysiological substrate for the development of life-threatening ventricular arrhythmias. Several recent studies7–12 have evaluated the relationship between patency of the infarct-related artery, the presence of late potentials detected by signal averaged ECG and subsequent mortality in patients with acute myocardial infarction.
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References
ISI-2 (Second International Study of Infarct Survival) Collaborative Group. Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. Lancet. 1988;2:349–60.
Wilcox RG, von der Lippe G, Olsson CG, Jensen G, Skene AM, Hampton JR. Trial of tissue plasminogen activator for mortality reduction in acute myocardial infarction: Anglo- Scandinavian Study of Early Thrombolysis (ASSET). Lancet. 1988;2:525–30.
Gruppo Italiano per lo Studio della Streptochinasi nell'Infarto Miocardico (GISSI) study. Long-term effects of intravenous thrombolysis in acute myocardial infarction: final report of the GISSI study. Lancet. 1987;2:871–4.
Califf RM, Topol EJ, Gersh BJ. From myocardial salvage to patient salvage in acute myocardial infarction: the role of perfusion therapy (editorial). J Am Coll Cardiol. 1989;14:1382–8.
Braunwald E. Myocardial reperfusion, reduction of infarct size, reduction of left ventricular dysfunction, and improved survival: should the paradigm be expanded? Circulation. 1989;79:441–4.
White HD, Norris RM, Brown MA et al. Effect of intravenous streptokinase on left ventricular function and early survival after acute myocardial infarction. N Engl J Med. 1987;317:850–5.
Gang ES, Lew AS, Hong M, Wang FZ, Siebert CA, Peter T. Decreased incidence of ventricular late potentials after successful thrombolytic therapy for acute myocardial infarction. N Engl J Med. 1989;321:712–6.
Turitto G, Risa AL, Zanchi E, Prati PL. The signal-averaged electrocardiogram and ventricular arrhythmias after thrombolysis for acute myocardial infarction. J Am Coll Cardiol. 1990;15:1270–6.
Tranchesi B, Verstraete M, Van de Werf F et al. Usefulness of high-frequency analysis of signal-averaged surface electrocardiograms in acute myocardial infarction before and after coronary thrombolysis for assessing coronary reperfusion. Am J Cardiol. 1990;66:1196–8.
Zimmermann M, Adamec R, Ciaroni S. Reduction in the frequency of ventricular late potentials after acute myocardial infarction by early thrombolytic therapy. Am J Cardiol. 1991;67:697–703.
Pedretti R, Laporta A, Etro MD et al. Influence of thrombolysis on signal-averaged electrocardiogram and late arrhythmic events after acute myocardial infarction. Am J Cardiol. 1992;69:866–72.
Vatterott PJ, Hammill SC, Bailey KR, Wiltgen CM, Gersh BJ. Late potentials on signal- averaged electrocardiograms and patency of the infarct-related artery in survivors of acute myocardial infarction. J Am Coll Cardiol. 1991;17:330–7.
Kawalsky DL, Garratt KN, Hammill SC, Bailey K, Gersh BJ. Infarct artery patency and late potentials after myocardial infarction: long-term follow-up. Circulation. 1991;84:II- 366.
Malik M, Kulakowski P, Odemuyiwa O et al. Effect of thrombolytic therapy on the predictive value of signal-averaged electrocardiography after acute myocardial infarction. Am J Cardiol. 1992;70:21–5.
Lacroix D, Kacet S, Dagano J et al. Signification pronostique et evolution des potentiels tardifs apres pontage aortocoronaire. Etude prospective chez 100 patients. Arch Mai Coeur. 1991;84:71–6.
Borbola J, Serry C, Goldin M, Denes P. Short-term effect of coronary artery bypass grafting on the signal-averaged electrocardiogram. Am J Cardiol. 1988;61:1001–5.
El-Sherif N, Scherlag BJ, Lazzara R, Hope RR. Re-entrant ventricular arrhythmias in the late myocardial infarction period. 1. Conduction characteristics in the infarction zone. Circulation. 1977;55:686–702.
Atie J, Brugada P, Smeets JLRM et al. Incidence of collateral blood supply to the infarcted area in patients with ventricular tachycardia after myocardial infarction (abstr). Circulation. 1989;80(suppl II):II-325.
Calkins H, Maughan WL, Weisman HF, Sugiura S, Sagawa K, Levine JH. Effect of acute volume load on refractoriness and arrhythmia development in isolated, chronically infarcted canine hearts. Circulation. 1989;79:687–97.
Reiter MJ, Synhorst DP, Mann DE. Electrophysiological effects of acute ventricular dilatation in the isolated rabbit heart. Circ Res. 1988;62 554–62.
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Hammill, S.C., Vatterott, P.J. (1993). The effect of reperfusion on the signal averaged ECG. In: Gomes, J.A. (eds) Signal Averaged Electrocardiography. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-0894-2_28
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DOI: https://doi.org/10.1007/978-94-011-0894-2_28
Publisher Name: Springer, Dordrecht
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