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European Heart Journal 1991 12(10):1070-1075;
Copyright © 1991 by the European Society of Cardiology.
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© 1991 The European Society of Cardiology

Independent prognostic value of supraventricular arrhythmias on 24-h ambulatory monitoring following myocardial infarction

C. C. DE COCK, F. C. VISSER, M. J. VAN EENIGE and J. P. ROOS

Department of Cardiology, Free University Hospital Amsterdam, The Netherlands

Received 16 August 1990; revised 2 November 1990; .

Correspondence: C. C. de Cock, Dept. of Cardiology, Free University Hospital. De Boelelaan 1117, 1007 MB Amsterdam, The Netherlands

Abstract

To determine the prognostic value of supraventricular arrhythmias, in addition to ventricular arrhythmias and clinical variables after myocardial infarction, 99 consecutive patients had 24-h ambulatory monitoring within 2 weeks of discharge. All patients completed at least 4-year follow-up (mean 56±6 month). During follow-up there were 29 cardiac events (13 cardiac deaths and 16 reinfarctions). The highest risk was associated with ventricular tachycardia (positive predictive accuracy 100%, negative predictive accuracy 75%, risk ratio 4 and supraventricular tachycardia i.e. paroxysmal tachycardia or AV nodal tachycardia (positive predictive accuracy 86%, negative predictive accuracy 80%, risk ratio 4 By multivariate analysis, sup raventricular tachycardia proved lobe an independent predictive variable, in addition to ventricular tachycardia, premature ventricular depolarisations≥10 h–1 and the presence of Killip class≥II while in the coronary care unit for future cardiac events. These data suggest that supraventricular tachycardias detected on 24-h ambulatory monitoring shortly after discharge carry a poor prognosis and may indicate a d pathophysiology as compared to ventricular tachycardias.

Key Words: Prognosis after myocardial infarction • supraventricular arrhythmias • 24-hour ambulatory monitoring


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