Skip to main content
Journal cover image

Reperfusion ventricular arrhythmia 'bursts' in TIMI 3 flow restoration with primary angioplasty for anterior ST-elevation myocardial infarction: a more precise definition of reperfusion arrhythmias.

Publication ,  Journal Article
Majidi, M; Kosinski, AS; Al-Khatib, SM; Lemmert, ME; Smolders, L; van Weert, A; Reiber, JHC; Tzivoni, D; Bär, FWHM; Wellens, HJJ; Gorgels, APM ...
Published in: Europace
August 2008

AIMS: We sought to define reperfusion-induced ventricular arrhythmias (VAs) more precisely through simultaneous angiography, continuous ST-segment recovery, and beat-to-beat Holter analyses in subjects with anterior ST-elevation myocardial infarction (STEMI) undergoing primary angioplasty [percutaneous coronary intervention (PCI)]. METHODS AND RESULTS: All 157 subjects with final TIMI 3 flow had continuous 12-lead electrocardiography with simultaneous Holter recording initiated prior to PCI for continuous ST-segment recovery and quantitative VA analyses. Ventricular arrhythmia bursts were detected against subject-specific background VA rates using a statistical outlier method. For temporal correlations, timing and quality of reperfusion were defined as first angiographic TIMI 3 flow with >or=50% stable ST-segment recovery. Almost all subjects had VAs [156/157 (99%)], whereas VA bursts during or subsequent to reperfusion occurred in 97/157 (62%). The majority of VA bursts (72%) arose within 20 min of reperfusion (95% CI: 26.7, 72), with onset at a median of 4 min post-reperfusion (IQR: 0-43) Bursts comprised a median of 1290 ventricular premature complexes (VPCs) (IQR: 415-4632) and persisted for a median of 105 min (IQR: 35-250). Most background VAs occurred as single VPCs; bursts typically comprised runs of three or more VPCs. Subjects with bursts had higher absolute peak ST segments and more frequent worsening of ST elevation immediately after reperfusion. CONCLUSION: Ventricular arrhythmia bursts temporally associated with TIMI 3 flow restoration and stable ST-segment recovery (reperfusion VA bursts) can be precisely defined in subjects with anterior STEMI and may constitute a unique electric biosignal of myocellular response to reperfusion.

Duke Scholars

Published In

Europace

DOI

EISSN

1532-2092

Publication Date

August 2008

Volume

10

Issue

8

Start / End Page

988 / 997

Location

England

Related Subject Headings

  • Terminology as Topic
  • Tachycardia, Ventricular
  • Myocardial Reperfusion Injury
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Internationality
  • Humans
  • Female
  • Electrocardiography
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Majidi, M., Kosinski, A. S., Al-Khatib, S. M., Lemmert, M. E., Smolders, L., van Weert, A., … Krucoff, M. W. (2008). Reperfusion ventricular arrhythmia 'bursts' in TIMI 3 flow restoration with primary angioplasty for anterior ST-elevation myocardial infarction: a more precise definition of reperfusion arrhythmias. Europace, 10(8), 988–997. https://doi.org/10.1093/europace/eun123
Majidi, Mohamed, Andrzej S. Kosinski, Sana M. Al-Khatib, Miguel E. Lemmert, Lilian Smolders, Anton van Weert, Johan H. C. Reiber, et al. “Reperfusion ventricular arrhythmia 'bursts' in TIMI 3 flow restoration with primary angioplasty for anterior ST-elevation myocardial infarction: a more precise definition of reperfusion arrhythmias.Europace 10, no. 8 (August 2008): 988–97. https://doi.org/10.1093/europace/eun123.
Majidi M, Kosinski AS, Al-Khatib SM, Lemmert ME, Smolders L, van Weert A, Reiber JHC, Tzivoni D, Bär FWHM, Wellens HJJ, Gorgels APM, Krucoff MW. Reperfusion ventricular arrhythmia 'bursts' in TIMI 3 flow restoration with primary angioplasty for anterior ST-elevation myocardial infarction: a more precise definition of reperfusion arrhythmias. Europace. 2008 Aug;10(8):988–997.
Journal cover image

Published In

Europace

DOI

EISSN

1532-2092

Publication Date

August 2008

Volume

10

Issue

8

Start / End Page

988 / 997

Location

England

Related Subject Headings

  • Terminology as Topic
  • Tachycardia, Ventricular
  • Myocardial Reperfusion Injury
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Internationality
  • Humans
  • Female
  • Electrocardiography