Ventricular arrhythmia burst is an independent indicator of larger infarct size even in optimal reperfusion in STEMI

Kirian van der Weg*, Mohamed Majidi, Joost D. E. Haeck, Jan G. P. Tijssen, Cynthia L. Green, Karel T. Koch, Wichert J. Kuijt, Mitchell W. Krucoff, Anton P. M. Gorgels, Robbert J. de Winter

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

6 Citations (Web of Science)

Abstract

Objective: We hypothesized that ventricular arrhythmia (VA) bursts during reperfusion phase are a marker of larger infarct size despite optimal epicardial and microvascular perfusion. Methods: 126 STEMI patients were studied with 24 h continuous, 12-lead Holter monitoring. Myocardial blush grade (MBG) was determined and VA bursts were identified against subject-specific background VA rates in core laboratories. Delayed-enhancement cardiovascular magnetic resonance imaging was used to determine infarct size. Results: In the group with MBG 3 no significant differences were found for baseline characteristics between burst versus no burst (102 vs. 24). In those with optimal epicardial and microvascular reperfusion (TIMI 3, stable ST-recovery, and MBG 3), VA burst was associated with larger infarct size (N = 102/126; median 11.0 vs. 5.1%; p = 0.004). Conclusion: In the event of MBG 3, VA bursts were associated with significantly larger infarct size even if optimal epicardial and microvascular reperfusion was present.
Original languageEnglish
Pages (from-to)345-352
JournalJournal of Electrocardiology
Volume49
Issue number3
DOIs
Publication statusPublished - 2016

Keywords

  • Myocardial infarction
  • Ventricular arrhythmias
  • Magnetic resonance imaging
  • Microvascular obstruction

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