TY - JOUR
T1 - Prognostic value of exercise-induced ventricular ectopic activity for mortality after acute myocardial infarction
AU - Henry, Rodney L.
AU - Kennedy, Gemma T.
AU - Crawford, Michael H.
N1 - Funding Information:
Fr011it he: Dc:tklrtmcnt of Mctlicinc:, Division of C;diolo~~, University of 1’~~~s H(!illth Science Ccntcr and the Autiic L Mur-I)hy hlemoriat Vctc:r;~ns I hospital. San Antonio. Texas. This strdy was supported in part by Training Grant ‘1’32 I-IL07350 Iron1 tho National Institutes of Health, Bcthcsda, Maryland, and ;I grant flom the ‘l’cxas Affiliate of the American Heart Association, Austin. ‘I’r:x,~s, and the Vctcrans Administration. Washington I1.C. M;~nusc:ript rrxeivetl Scptcmbcr 29, 1986; revised manuscript rcccivcd Januar! ’ 20. 1987. accc~~tccl january 2 1. 1987.
PY - 1987/6/1
Y1 - 1987/6/1
N2 - To evaluate the importance of ventricular ectopic activity on the predischarge treadmill exercise test for predicting mortality in patients after acute myocardial infarction (AMI), 163 patients with uncomplicated AMI were studied using symptom limited low-level treadmill exercise testing and 24-hour ambulatory electrocardiographic monitoring before hospital discharge. All patients were followed for at least 2 years or until recurrent AMI, coronary artery bypass grafting or death. Seventeen patients (10%) died during the follow-up period, 15 patients (9%) had recurrent AMI and 45 patients (28%) underwent bypass surgery. Ventricular ectopic activity was the only single treadmill abnormality that predicted subsequent cardiac death; angina pectoris, electrocardiographic ST-segment depression and a hypotensive blood pressure response did not. The mortality rate in the 20 patients with exercise induced ventricular ectopic activity was 25%, compared with 8% in those without (p < 0.004). Furthermore, in this patient population, exercise-induced ventricular ectopic activity was a much better predictor of cardiac death than that detected by ambulatory monitoring. Thus, ventricular ectopic activity on the predischarge treadmill exercise test is an important risk factor for death after AMI.
AB - To evaluate the importance of ventricular ectopic activity on the predischarge treadmill exercise test for predicting mortality in patients after acute myocardial infarction (AMI), 163 patients with uncomplicated AMI were studied using symptom limited low-level treadmill exercise testing and 24-hour ambulatory electrocardiographic monitoring before hospital discharge. All patients were followed for at least 2 years or until recurrent AMI, coronary artery bypass grafting or death. Seventeen patients (10%) died during the follow-up period, 15 patients (9%) had recurrent AMI and 45 patients (28%) underwent bypass surgery. Ventricular ectopic activity was the only single treadmill abnormality that predicted subsequent cardiac death; angina pectoris, electrocardiographic ST-segment depression and a hypotensive blood pressure response did not. The mortality rate in the 20 patients with exercise induced ventricular ectopic activity was 25%, compared with 8% in those without (p < 0.004). Furthermore, in this patient population, exercise-induced ventricular ectopic activity was a much better predictor of cardiac death than that detected by ambulatory monitoring. Thus, ventricular ectopic activity on the predischarge treadmill exercise test is an important risk factor for death after AMI.
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U2 - 10.1016/0002-9149(87)90899-X
DO - 10.1016/0002-9149(87)90899-X
M3 - Article
C2 - 3591677
AN - SCOPUS:0023161562
VL - 59
SP - 1251
EP - 1255
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 15
ER -