European Heart Journal Advance Access published online on March 18, 2005
European Heart Journal, doi:10.1093/eurheartj/ehi188
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1 Division of Cardiology, Department of Internal Medicine, University of Oulu, PO Box 5000 (Kajaanintie 50), FIN-90014, Oulu, Finland
* To whom correspondence should be addressed. Aims Current treatment may have changed the risk profiles of survivors of acute myocardial infarction (AMI). We evaluated the utility of Holter-based risk variables in the prediction of sudden cardiac death (SCD) among survivors of AMI treated with modern therapy. Methods and results A total of 2130 AMI patients (mean age 59±10 years) were included. The patients were treated with modern therapeutic strategies, for example, 94% were on Conclusion Among the post-AMI patients treated according to the current guidelines, the incidence of SCD is low. Various Holter variables still predict the occurrence of SCD, particularly among the patients with preserved left ventricular function.
Received August 29, 2004
Revised January 17, 2005
Accepted January 20, 2005
Clinical research
Prediction of sudden cardiac death after acute myocardial infarction: role of Holter monitoring in the modern treatment era
2 Deutsches Herzzentrum und 1 Medizinische Klinik der Technischen Universität München, Munich, Germany
Timo H. Mäkikallio, E-mail: timo.makikallio{at}oulu.fi
Abstract 
-blocking therapy and 70% underwent coronary revascularization. Various risk parameters from Holter monitoring were analysed. During a median follow-up of 1012 days (interquartile range: 750-1416 days), cardiac mortality was 113/2130, including 52 SCDs. All Holter variables predicted the occurrence of SCD (P<0.01), but only reduced post-ectopic turbulence slope (TS) (P<0.001) and non-sustained ventricular tachycardia (P<0.01) remained as marked SCD predictors after adjustment for age, diabetes, and ejection fraction (EF). In a subgroup analysis, none of the Holter variables predicted SCD among those with an EF 
0.35, but many variables predicted SCD among those with an EF >0.35, particularly TS (hazard ratio 5.9; 95% CI 2.9-11.7, P<0.001).
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