PMID: 8606269Mar 1, 1996Paper

Exercise-induced ischemic arrhythmias in patients with previous myocardial infarction: role of perfusion and tissue viability

Journal of the American College of Cardiology
A MargonatoS L Chierchia

Abstract

This study sought to investigate whether residual viability of infarcted myocardium may play a role in the pathogenesis of exercise-induced ventricular arrhythmias. We previously showed that transient ischemia within partially infarcted areas often precipitates ventricular arrhythmias during exercise that are consistently obliterated by intravenous nitrates. We studied 60 patients with chronic stable angina and a previous myocardial infarction. All underwent at least two consecutive exercise stress tests, coronary angiography and stress/rest myocardial perfusion tomography by Tc-99m 2-methoxy isobutyl isonitrile (MIBI). In the last 26 consecutive patients, residual viability was assessed by single-photon emission computed tomography (SPECT) using fluorine (F)-18 fluorodeoxyglucose. Perfusion and metabolic data were evaluated qualitatively by three independent observers in blinded manner. With exercise, 30 patients (group A) consistently developed ventricular arrhythmias (> 10 ventricular ectopic beats/min, couplets, nonsustained ventricular tachycardia); the remaining 30 patients (group B) did not. The severity of coronary artery disease (Gensini score) was similar in the two groups. Postexercise SPECT showed partial reperfusio...Continue Reading

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Citations

May 14, 2003·Journal of the American College of Cardiology·Douglas S LeeDavid A Alter
Mar 27, 2010·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Stefan de HaanCornelis P Allaart
Jan 9, 2010·Circulation Journal : Official Journal of the Japanese Circulation Society·Gang HuangYue-Hui Yin
Sep 25, 1999·Japanese Circulation Journal·T TakezakoK Arakawa
Nov 4, 2000·Clinical Cardiology·P Perrone-FilardiR Underwood
Jan 7, 2011·Heart Failure Reviews·Francisco Leyva, Paul W X Foley
Dec 17, 2015·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Mischa T RijniersePaul Knaapen

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