Skip to main content
British Heart Journal logoLink to British Heart Journal
. 1975 Nov;37(11):1169–1175. doi: 10.1136/hrt.37.11.1169

Relation between infarct size and ventricular arrhythmia.

R Roberts, A Husain, H D Ambos, G C Oliver, J R Cox Jr, B E Sobel
PMCID: PMC482935  PMID: 53056

Abstract

In order to determine whether ventricular arrhythmia is quantitatively related to infarct size estimated enzymatically we studied 31 patients with acute myocardial infarction without cargiogenic shock. Infarct size index was estimated from hourly serum creatine kinase (CK) changes during periods of 48 to 72 hours. Ventricular arrhythmia was quantified by automated analysis of continuous electrocardiographic recordings over a period of 20 hours with the use of the Argus/H computer system. Patients were classified into three groups according to infarct size index. Patients in all groups had similar average heart rate, blood pressure, serum potassium, and arterial pH and PCO2 values during the first 10 hours after admission. The total number of ventricular ectopic beats (VEB), frequency of couplets, and ventricular tachycardia, and peak rate of ventricular ectopic beats during the first 10 hours after admission were all related to infarct size index. For example, patients with small, medium, and large estimated infarct size averaged 26, 104, and 405 ventricular ectopic beats, respectively. These results suggest that the severity of ventricular arrhythmia early after myocardial infarction is related to the extent of myocardial injury as estimated enzymatically. Thus the apparent efficacy and therefore the evaluation of antiarrhythmic agents early after myocardial infarction may be influenced by the magnitude of injury sustained by the heart.

Full text

PDF
1169

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ALLEN J. B., LEADT J. R. The effect of the level of the ligature on mortality following ligation of the circumflex coronary artery in the dog. Am Heart J. 1950 Feb;39(2):273–278. doi: 10.1016/0002-8703(50)90221-3. [DOI] [PubMed] [Google Scholar]
  2. Bloor C. M., Ehsani A., White F. C., Sobel B. E. Ventricular fibrillation threshold in acute myocardial infarction and its relation to myocardial infarct size. Cardiovasc Res. 1975 Jul;9(4):468–472. doi: 10.1093/cvr/9.4.468. [DOI] [PubMed] [Google Scholar]
  3. Chapman B. L. Relation of cardiac complications to SGOT level in acute myocardial infarction. Br Heart J. 1972 Sep;34(9):890–896. doi: 10.1136/hrt.34.9.890. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. HARRIS A. S., BISTENI A., RUSSELL R. A., BRIGHAM J. C., FIRESTONE J. E. Excitatory factors in ventricular tachycardia resulting from myocardial ischemia; potassium a major excitant. Science. 1954 Feb 12;119(3085):200–203. doi: 10.1126/science.119.3085.200. [DOI] [PubMed] [Google Scholar]
  5. Jewitt D. E., Reid D., Thomas M., Mercer C. J., Valori C., Shillingford J. P. Free noradrenaline and adrenaline excretion in relation to the development of cardiac arrhythmias and heart-failure in patients with acute myocardial infarction. Lancet. 1969 Mar 29;1(7596):635–641. doi: 10.1016/s0140-6736(69)92009-1. [DOI] [PubMed] [Google Scholar]
  6. Kibe O., Nilsson N. J. Observations on the diagnostic and prognostic value of some enzyme tests in myocardial infarction. Acta Med Scand. 1967 Nov;182(5):597–610. doi: 10.1111/j.0954-6820.1967.tb10886.x. [DOI] [PubMed] [Google Scholar]
  7. Killip T. Arrhythmia, sudden death and coronary artery disease. Am J Cardiol. 1971 Nov;28(5):614–616. doi: 10.1016/0002-9149(71)90106-8. [DOI] [PubMed] [Google Scholar]
  8. Kostuk W. J., Ehsani A. A., Karliner J. S., Ashburn W. L., Peterson K. L., Ross J., Jr, Sobel B. E. Left ventricular performance after myocardial infarction assessed by radioisotope angiocardiography. Circulation. 1973 Feb;47(2):242–249. doi: 10.1161/01.cir.47.2.242. [DOI] [PubMed] [Google Scholar]
  9. Nielsen B. L. ST-segment elevation in acute myocardial infarction. Prognostic importance. Circulation. 1973 Aug;48(2):338–345. doi: 10.1161/01.cir.48.2.338. [DOI] [PubMed] [Google Scholar]
  10. Norris R. M., Brandt P. W., Caughey D. E., Lee A. J., Scott P. J. A new coronary prognostic index. Lancet. 1969 Feb 8;1(7589):274–278. doi: 10.1016/s0140-6736(69)91035-6. [DOI] [PubMed] [Google Scholar]
  11. Norris R. M., Brandt P. W., Lee A. J. Mortality in a coronary-care unit analysed by a new coronary prognostic index. Lancet. 1969 Feb 8;1(7589):278–281. doi: 10.1016/s0140-6736(69)91036-8. [DOI] [PubMed] [Google Scholar]
  12. Norris R. M., Whitlock R. M., Barratt-Boyes C., Small C. W. Clinical measurement of myocardial infarct size. Modification of a method for the estimation of total creatine phosphokinase release after myocardial infarction. Circulation. 1975 Apr;51(4):614–620. doi: 10.1161/01.cir.51.4.614. [DOI] [PubMed] [Google Scholar]
  13. Oliver M. F., Kurien V. A., Greenwood T. W. Relation between serum-free-fatty acids and arrhythmias and death after acute myocardial infarction. Lancet. 1968 Apr 6;1(7545):710–714. doi: 10.1016/s0140-6736(68)92163-6. [DOI] [PubMed] [Google Scholar]
  14. Opie L. H., Owen P., Thomas M., Samson R. Coronary sinus lactate measurements in assessment of myocardial ischemia. Comparison with changes in lactate-pyruvate and beta-hydroxybutyrate-acetoacetate ratios and with release of hydrogen, phosphate and potassium ions from the heart. Am J Cardiol. 1973 Sep 7;32(3):295–305. doi: 10.1016/s0002-9149(73)80137-7. [DOI] [PubMed] [Google Scholar]
  15. Shell W. E., Kjekshus J. K., Sobel B. E. Quantitative assessment of the extent of myocardial infarction in the conscious dog by means of analysis of serial changes in serum creatine phosphokinase activity. J Clin Invest. 1971 Dec;50(12):2614–2625. doi: 10.1172/JCI106762. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Skjaeggestad O. Arrhythmias in different types of acute coronary heart diseases. Acta Med Scand. 1973 Apr;193(4):299–302. doi: 10.1111/j.0954-6820.1973.tb10580.x. [DOI] [PubMed] [Google Scholar]
  17. Sobel B. E., Bresnahan G. F., Shell W. E., Yoder R. D. Estimation of infarct size in man and its relation to prognosis. Circulation. 1972 Oct;46(4):640–648. doi: 10.1161/01.cir.46.4.640. [DOI] [PubMed] [Google Scholar]
  18. Spracklen F. H., Besterman E. M., Everest M. S., Litchfield J. W., Petrie M. Late ventricular dysrhythmias after myocardial infarction. Br Med J. 1968 Nov 9;4(5627):364–366. doi: 10.1136/bmj.4.5627.364. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Surawicz B. Ventricular fibrillation. Am J Cardiol. 1971 Sep;28(3):268–287. doi: 10.1016/0002-9149(71)90115-9. [DOI] [PubMed] [Google Scholar]
  20. Thomas M., Shulman G., Opie L. Arteriovenous potassium changes and ventricular arrhythmias after coronary artery occlusion. Cardiovasc Res. 1970 Jul;4(3):327–333. doi: 10.1093/cvr/4.3.327. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES