Time Dependence of Ventricular Tachyarrhythmias After Myocardial Infarction: A MADIT-CRT Substudy.

JACC. Clinical Electrophysiology
Mehmet F OzluMehmet K Aktas

Abstract

The purpose of this study was to assess the relationship between the time since a myocardial infarction (MI) and the risk of ventricular tachyarrhythmic events (VTEs) in patients with left ventricular dysfunction and mild symptoms of heart failure. Patients with left ventricular dysfunction after MI are at high risk for VTEs. Ventricular tachycardia (VT), ventricular fibrillation (VF), or death as a function of time since MI was assessed in 693 patients enrolled in the MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy). Patients were categorized as those with a period of <3 years since an MI (lowest quartile, n = 172) versus those with a period of ≥3 years since an MI (n = 521). Risk of VT/VF or death was compared. Cumulative probability of VT/VF or death was significantly higher among patients in the highest quartile of time since an MI compared with those in the lowest quartile (41% vs. 22%, p = 0.015). Multivariate analysis showed that in patients with left bundle branch block (LBBB), those with a period of ≥3 years since an MI had a significantly higher risk of VT/VF or death (hazard ratio: 2.33; 95% confidence interval: 1.43 to 3.80; p = 0.001) and a higher risk of VT/VF (h...Continue Reading

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