Park, Yae Min; Kang, Woong Chol; Suh, Soon Yong; Lee, Kyunghoon; Han, Seung Hwan; Shin, Mi-Seung; Koh, Kwang Kon; Ahn, Taehoon; Kim, Young-Hoon; Choi, In Suck; Shin, Eak Kyun
International journal of cardiology
2014Sep ; 176 ( 2 ) :327-32.
PMID : 25091722
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Park, Yae Min - Cardiology Division, Gachon University Gil Medical Center, Incheon, Korea.
Kang, Woong Chol - Cardiology Division, Gachon University Gil Medical Center, Incheon, Korea.
Suh, Soon Yong - Cardiology Division, Gachon University Gil Medical Center, Incheon, Korea.
Lee, Kyunghoon - Cardiology Division, Gachon University Gil Medical Center, Incheon, Korea.
Han, Seung Hwan - Cardiology Division, Gachon University Gil Medical Center, Incheon, Korea.
Shin, Mi-Seung - Cardiology Division, Gachon University Gil Medical Center, Incheon, Korea.
Koh, Kwang Kon - Cardiology Division, Gachon University Gil Medical Center, Incheon, Korea.
Ahn, Taehoon - Cardiology Division, Gachon University Gil Medical Center, Incheon, Korea.
Kim, Young-Hoon - Cardiology Division, Korea University Anam Hospital, Seoul, Korea.
Choi, In Suck - Cardiology Division, Gachon University Gil Medical Center, Incheon, Korea. Electronic address cis@gilhospital.com.
Shin, Eak Kyun - Cardiology Division, Gachon University Gil Medical Center, Incheon, Korea.
ABSTRACT
BACKGROUND: Recent studies found that early repolarization (ER) is significantly more common in survivors of aborted sudden cardiac death. We hypothesized that ER might be more common in patients with ST elevation myocardial infarction (STEMI) who have complications of atrial and ventricular arrhythmias.
METHODS: This study included 266 patients with acute STEMI undergoing primary percutaneous coronary intervention. Twelve-lead electrocardiograms were analyzed for ER, defined as J-point elevation ??0.1 mV and "notching" and "slurring" of the terminal part of the QRS complex in at least 2 lateral or inferior leads. Acute and late atrial and ventricular arrhythmic events were evaluated.
RESULTS: The ER pattern was observed in 76 patients (28.6%). Atrial arrhythmia [21/76 (27.6%) vs. 22/190 (11.6%), p=0.001] and ventricular arrhythmia [16/76 (21.1%) vs. 16/190 (8.4%), p=0.004] were more frequently complicated in patients with ER than those without during hospitalization. ER was a significant independent predictor of developing atrial (HR=2.682, 95% CI=1.355-5.310, p=0.005) and ventricular arrhythmia (HR=2.936, 95% CI=1.360-6.335, p=0.006). Three patients with ER and ventricular fibrillation expired during hospitalization [3.9% (3/76) vs. 0% (0/190), p=0.023]. However, the presence of ER did not affect the late recurrence of atrial and ventricular arrhythmia.
CONCLUSIONS: The ER pattern is commonly observed in patients with STEMI and associated with atrial and ventricular tachyarrhythmia during acute setting. CI - Copyright ??2014 Elsevier Ireland Ltd. All rights reserved.
keyword
Atrial and ventricular arrhythmia; Early repolarization (ER); ST elevation myocardial infarction (STEMI)
MESH
Aged, Electrocardiography/trends, Female, Follow-Up Studies, Humans, Male, Middle Aged, Myocardial Infarction/*diagnosis/epidemiology/physiopathology, Percutaneous Coronary Intervention/*trends, Retrospective Studies, Risk Factors, Tachycardia, Supraventricular/*diagnosis/epidemiology/physiopathology, Tachycardia, Ventricular/*diagnosis/epidemiology/physiopathology, Time Factors
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