Abstract
The occurrence of ventricular late potentials in survivors of acute myocardial infarction treated with intravenous streptokinase was compared with that in a conservatively treated group and the relation between ventricular late potentials and patency of the infarct related artery was examined. Of 115 patients admitted with a first infarct, 55 were treated with intravenous streptokinase (streptokinase group) and 60 were treated conservatively (non-streptokinase group). A signal averaged electrocardiogram was recorded in all patients and coronary angiography was performed in 45 (81.8%) of the streptokinase group and in 21 (35%) of the non-streptokinase group. At a 40 Hz filter setting ventricular late potentials were significantly less common in patients treated with streptokinase (9 (16.4%) of 55) than in those who were not (26 (43.3%) of 60). A total of 66 patients underwent angiography. Of the 26 who had closed infarct-related arteries, 17 had ventricular late potentials at a 40 Hz filter setting (sensitivity 65.4%, specificity 95%) and 38 of the 40 patients with a patent infarct-related artery did not have ventricular late potentials (sensitivity 80.9%, specificity 89.5%). Patients with acute myocardial infarction treated with intravenous streptokinase were significantly less likely to have ventricular late potentials than conservatively treated patients and the absence of ventricular late potentials at 40 Hz filter setting was a good non-invasive predictor that the infarct-related artery was patent.
Full text
PDF



Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Berbari E. J., Scherlag B. J., Hope R. R., Lazzara R. Recording from the body surface of arrhythmogenic ventricular activity during the S-T segment. Am J Cardiol. 1978 Apr;41(4):697–702. doi: 10.1016/0002-9149(78)90820-2. [DOI] [PubMed] [Google Scholar]
- Boineau J. P., Cox J. L. Slow ventricular activation in acute myocardial infarction. A source of re-entrant premature ventricular contractions. Circulation. 1973 Oct;48(4):702–713. doi: 10.1161/01.cir.48.4.702. [DOI] [PubMed] [Google Scholar]
- Braunwald E. Myocardial reperfusion, limitation of infarct size, reduction of left ventricular dysfunction, and improved survival. Should the paradigm be expanded? Circulation. 1989 Feb;79(2):441–444. doi: 10.1161/01.cir.79.2.441. [DOI] [PubMed] [Google Scholar]
- Breithardt G., Borggrefe M. Pathophysiological mechanisms and clinical significance of ventricular late potentials. Eur Heart J. 1986 May;7(5):364–385. doi: 10.1093/oxfordjournals.eurheartj.a062078. [DOI] [PubMed] [Google Scholar]
- Breithardt G., Schwarzmaier J., Borggrefe M., Haerten K., Seipel L. Prognostic significance of late ventricular potentials after acute myocardial infarction. Eur Heart J. 1983 Jul;4(7):487–495. doi: 10.1093/oxfordjournals.eurheartj.a061506. [DOI] [PubMed] [Google Scholar]
- Chesebro J. H., Knatterud G., Roberts R., Borer J., Cohen L. S., Dalen J., Dodge H. T., Francis C. K., Hillis D., Ludbrook P. Thrombolysis in Myocardial Infarction (TIMI) Trial, Phase I: A comparison between intravenous tissue plasminogen activator and intravenous streptokinase. Clinical findings through hospital discharge. Circulation. 1987 Jul;76(1):142–154. doi: 10.1161/01.cir.76.1.142. [DOI] [PubMed] [Google Scholar]
- Denes P., Santarelli P., Hauser R. G., Uretz E. F. Quantitative analysis of the high-frequency components of the terminal portion of the body surface QRS in normal subjects and in patients with ventricular tachycardia. Circulation. 1983 May;67(5):1129–1138. doi: 10.1161/01.cir.67.5.1129. [DOI] [PubMed] [Google Scholar]
- Eldar M., Leor J., Hod H., Rotstein Z., Truman S., Kaplinsky E., Abboud S. Effect of thrombolysis on the evolution of late potentials within 10 days of infarction. Br Heart J. 1990 May;63(5):273–276. doi: 10.1136/hrt.63.5.273. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gang E. S., Lew A. S., Hong M., Wang F. Z., Siebert C. A., Peter T. Decreased incidence of ventricular late potentials after successful thrombolytic therapy for acute myocardial infarction. N Engl J Med. 1989 Sep 14;321(11):712–716. doi: 10.1056/NEJM198909143211104. [DOI] [PubMed] [Google Scholar]
- Gardner P. I., Ursell P. C., Fenoglio J. J., Jr, Wit A. L. Electrophysiologic and anatomic basis for fractionated electrograms recorded from healed myocardial infarcts. Circulation. 1985 Sep;72(3):596–611. doi: 10.1161/01.cir.72.3.596. [DOI] [PubMed] [Google Scholar]
- Gomes J. A., Mehra R., Barreca P., el-Sherif N., Hariman R., Holtzman R. Quantitative analysis of the high-frequency components of the signal-averaged QRS complex in patients with acute myocardial infarction: a prospective study. Circulation. 1985 Jul;72(1):105–111. doi: 10.1161/01.cir.72.1.105. [DOI] [PubMed] [Google Scholar]
- Gomes J. A., Winters S. L., Stewart D., Targonski A., Barreca P. Optimal bandpass filters for time-domain analysis of the signal-averaged electrocardiogram. Am J Cardiol. 1987 Dec 1;60(16):1290–1298. doi: 10.1016/0002-9149(87)90610-2. [DOI] [PubMed] [Google Scholar]
- Kersschot I. E., Brugada P., Ramentol M., Zehender M., Waldecker B., Stevenson W. G., Geibel A., De Zwaan C., Wellens H. J. Effects of early reperfusion in acute myocardial infarction on arrhythmias induced by programmed stimulation: a prospective, randomized study. J Am Coll Cardiol. 1986 Jun;7(6):1234–1242. doi: 10.1016/s0735-1097(86)80141-3. [DOI] [PubMed] [Google Scholar]
- Kim S. G. The management of patients with life-threatening ventricular tachyarrhythmias: programmed stimulation or Holter monitoring (either or both)? Circulation. 1987 Jul;76(1):1–5. doi: 10.1161/01.cir.76.1.1. [DOI] [PubMed] [Google Scholar]
- Kuchar D. L., Thorburn C. W., Sammel N. L. Late potentials detected after myocardial infarction: natural history and prognostic significance. Circulation. 1986 Dec;74(6):1280–1289. doi: 10.1161/01.cir.74.6.1280. [DOI] [PubMed] [Google Scholar]
- McGuire M., Kuchar D., Ganis J., Sammel N., Thorburn C. Natural history of late potentials in the first ten days after acute myocardial infarction and relation to early ventricular arrhythmias. Am J Cardiol. 1988 Jun 1;61(15):1187–1190. doi: 10.1016/0002-9149(88)91152-6. [DOI] [PubMed] [Google Scholar]
- Pollak S. J., Kertes P. J., Bredlau C. E., Walter P. F. Influence of left ventricular function on signal averaged late potentials in patients with coronary artery disease with and without ventricular tachycardia. Am Heart J. 1985 Oct;110(4):747–752. doi: 10.1016/0002-8703(85)90452-1. [DOI] [PubMed] [Google Scholar]
- Richardson S. G., Morton P., Murtagh J. G., Scott M. E., O'Keeffe D. B. Relation of coronary arterial patency and left ventricular function to electrocardiographic changes after streptokinase treatment during acute myocardial infarction. Am J Cardiol. 1988 May 1;61(13):961–965. doi: 10.1016/0002-9149(88)90106-3. [DOI] [PubMed] [Google Scholar]
- Simoons M. L., Serruys P. W., vd Brand M., Bär F., de Zwaan C., Res J., Verheugt F. W., Krauss X. H., Remme W. J., Vermeer F. Improved survival after early thrombolysis in acute myocardial infarction. A randomised trial by the Interuniversity Cardiology Institute in The Netherlands. Lancet. 1985 Sep 14;2(8455):578–582. doi: 10.1016/s0140-6736(85)90584-7. [DOI] [PubMed] [Google Scholar]
- Simson M. B., Untereker W. J., Spielman S. R., Horowitz L. N., Marcus N. H., Falcone R. A., Harken A. H., Josephson M. E. Relation between late potentials on the body surface and directly recorded fragmented electrograms in patients with ventricular tachycardia. Am J Cardiol. 1983 Jan 1;51(1):105–112. doi: 10.1016/s0002-9149(83)80020-4. [DOI] [PubMed] [Google Scholar]
- Simson M. B. Use of signals in the terminal QRS complex to identify patients with ventricular tachycardia after myocardial infarction. Circulation. 1981 Aug;64(2):235–242. doi: 10.1161/01.cir.64.2.235. [DOI] [PubMed] [Google Scholar]
- Vermeer F., Simoons M. C., Lubsen J. Reduced frequency of ventricular fibrillation after early thrombolysis in myocardial infarction. Lancet. 1986 May 17;1(8490):1147–1148. doi: 10.1016/s0140-6736(86)91855-6. [DOI] [PubMed] [Google Scholar]
- Verzoni A., Romano S., Pozzoni L., Tarricone D., Sangiorgio S., Croce L. Prognostic significance and evolution of late ventricular potentials in the first year after myocardial infarction: a prospective study. Pacing Clin Electrophysiol. 1989 Jan;12(1 Pt 1):41–51. doi: 10.1111/pace.1989.12.p1.41. [DOI] [PubMed] [Google Scholar]
- Yusuf S., Collins R., Peto R., Furberg C., Stampfer M. J., Goldhaber S. Z., Hennekens C. H. Intravenous and intracoronary fibrinolytic therapy in acute myocardial infarction: overview of results on mortality, reinfarction and side-effects from 33 randomized controlled trials. Eur Heart J. 1985 Jul;6(7):556–585. doi: 10.1093/oxfordjournals.eurheartj.a061905. [DOI] [PubMed] [Google Scholar]