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Haghjoo M, Kiani R, Fazelifar AF, et al. Early risk stratification for arrhythmic death in patients with ST-elevation myocardial infarction. Indian Pacing Electrophysiol J. 2007;7(1):19-25
Haghjoo, M., Kiani, R., Fazelifar, A. F., Alizadeh, A., Emkanjoo, Z., & Sadr-Ameli, M. A. (2007). Early risk stratification for arrhythmic death in patients with ST-elevation myocardial infarction. Indian pacing and electrophysiology journal, 7(1), 19-25.
Haghjoo, Majid, et al. "Early risk stratification for arrhythmic death in patients with ST-elevation myocardial infarction." Indian pacing and electrophysiology journal vol. 7,1 (2007): 19-25.
Haghjoo M, Kiani R, Fazelifar AF, Alizadeh A, Emkanjoo Z, Sadr-Ameli MA. Early risk stratification for arrhythmic death in patients with ST-elevation myocardial infarction. Indian Pacing Electrophysiol J. 2007 Jan 01;7(1):19-25. PMID: 17235369; PMCID: PMC1766332.
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Indian Pacing Electrophysiol J. 2007 Jan 01;7(1):19-25.

Early risk stratification for arrhythmic death in patients with ST-elevation myocardial infarction.

Indian pacing and electrophysiology journal

Majid Haghjoo, Reza Kiani, Amir Farjam Fazelifar, Abolfath Alizadeh, Zahra Emkanjoo, Mohammad Ali Sadr-Ameli

Affiliations

  1. Department of Pacemaker and Electrophysiology, Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. [email protected]

PMID: 17235369 PMCID: PMC1766332

Abstract

BACKGROUND: Sudden cardiac death is a leading cause of death in patients with ST-elevation myocardial infarction (MI). According to high cost of modern therapeutic modalities it is of paramount importance to define protocols for risk stratification of post-MI patients before considering expensive devices such as implantable cardioverter-defibrillator.

METHODS: One hundred and thirty seven patients with acute ST-elevation MI were selected and underwent echocardiographic study, holter monitoring and signal-averaged electrocardiography (SAECG). Then, the patients were followed for 12 +/-3 months.

RESULTS: During follow-up, 13 deaths (9.5%) occurred; nine cases happened as sudden cardiac death (6.6%). The effect of ejection fraction (EF) less than 40% on occurrence of arrhythmic events was significant (P<0.001). Sensitivity and positive predictive value of EF<40% was 100% and 76.95% respectively. Although with lesser sensitivity and predictive power than EF<40%, abnormal heart rate variability (HRV) and SAECG had also significant effects on occurrence of sudden death (P=0.02 and P=0.003 respectively). Nonsustained ventricular tachycardia was not significantly related to risk of sudden death in this study (P=0.20).

CONCLUSION: This study indicated that EF less than 40% is the most powerful predictor of sudden cardiac death in post MI patients. Abnormal HRV and SAECG are also important predictors and can be added to EF for better risk stratification.

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