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Abstract
Sustained infarct artery patency is an important determinant of survival in patients
with acute myocardial infarction. We studied 61 patients with acute myocardial infarction
who received intravenous recombinant tissue-type plasminogen activator, aspirin or
heparin within 6 hours of symptom onset, to determine if infarct artery patency after
intravenous thrombolytic therapy influences myocardial electrical stability as measured
by the prevalence of spontaneous ventricular ectopy or late potential activity. Infarct
artery patency was determined by angiographic evaluation 2.5 ± 3 days after infarction.
Forty-eight patients (79%) had a patent infarct-related artery and 13 (21%) patients
had an occluded vessel. The mean number of ventricular premature complexes (VPCs)/hour
(p < 0.01) and the prevalence of late potentials (54 vs 19%; p < 0.03) were significantly
higher in patients with an occluded versus patent-infarct related vessel. Although
VPC frequency and late potentials were not influenced by the time to thrombolytic
treatment, patients with a patent infarct-related artery had a lower prevalence of
late potentials regardless of whether treatment was initiated ≤2 hours (25% patent
vs 50% occluded; p = not significant) or 2 to 6 hours (16% patent vs 55% occluded;
p > 0.03) after symptom onset.
Thus, successful thrombolysis decreases the frequency of ventricular ectopic activity
and late potentials in the early postinfarction phase. The reduction in both markers
of electrical instability may help explain why the prognosis after successful thrombolysis
is improved after acute myocardial infarction.
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Article info
Publication history
Accepted:
July 9,
1991
Received:
May 20,
1991
Identification
Copyright
© 1991 Published by Elsevier Inc.
