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European Heart Journal 1982 3(1):67-74;
Copyright © 1982 by the European Society of Cardiology.
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© 1982 by The European Society of Cardiology

Reliability of serial 24 h ambulatory electrocardiography in predicting cardiac death after myocardial infarction

M. MØLLER

Departments of Cardiology B and Clinical Physiology, Odense University Hospital Denmark

Received 27 March 1981; revised 2 July 1981; .

Request for reprint to: Mogens MØLLER,MD, Department of Cardiology B.Odense University Hospital. DK-5000 Odense C. Denmark

Abstract

One hundred consecutive patients below the age of 70 years, surviving an acute myocardial infarction, were subjected to 24-h electrocardiographic monitoring during the late hospital phase, as well as at one, three and six months after the infarction. Complex ventricular arrhythmias (multiform, couplets, R on T, ventricular tachycardia) were found in 34, 51, 41 and 39% of the patients on the four occasions, respectively. Thus a significant increase was found in relation to discharge (34 v. 51%, P <0.05). The cumulative percentage of patients with complex arrhythmias was 34, 65, 74 and 79% respectively, indicating a considerable intra-individual variation from time to time. Complex ventricular arrhythmias were found in only six patients during all monitorings. A close correlation between the quantitative and qualitative arrhythmia pattern was demonstrated. Nineteen cases of cardiac death occurred during an average follow-up period of 30 (range 27–34) months. During the late hospital phase, but not afterwards, complex ventricular arrhythmias were significantly more frequent in patients who subsequently had cardiac death (P <0.05). In 11 patients who had cardiac death, their final monitoring was without complex ventricular arrhythmias. As these arrhythmias were demonstrated in the large majority of patients and showed a considerable variation from time to time in the individual patient, even serial 24 h ambulatory electrocardiography has severe limitations in identifying well-defined high or low risk groups after myocardial infarction.

Key Words: Ambulatory electrocardiography • ventricular arrhythmias • cardiac death


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