TY - JOUR
T1 - Ventricular arrhythmia burst is an independent indicator of larger infarct size even in optimal reperfusion in STEMI
AU - van der Weg, Kirian
AU - Majidi, Mohamed
AU - Haeck, Joost D. E.
AU - Tijssen, Jan G. P.
AU - Green, Cynthia L.
AU - Koch, Karel T.
AU - Kuijt, Wichert J.
AU - Krucoff, Mitchell W.
AU - Gorgels, Anton P. M.
AU - de Winter, Robbert J.
PY - 2016
Y1 - 2016
N2 - 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.
AB - 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.
KW - Myocardial infarction
KW - Ventricular arrhythmias
KW - Magnetic resonance imaging
KW - Microvascular obstruction
U2 - 10.1016/j.jelectrocard.2016.03.013
DO - 10.1016/j.jelectrocard.2016.03.013
M3 - Article
SN - 0022-0736
VL - 49
SP - 345
EP - 352
JO - Journal of Electrocardiology
JF - Journal of Electrocardiology
IS - 3
ER -