Patients with late potentials on the signal averaged electrocardiogram
(SAECG) are more at risk of lethal an-hythmias in the period after acute
myocardial infarction ( ). To assess the effect of intravenous thrombolysis
on the incidence of ventricular late potentials. 68 patients surviving a
first anterior AM. were included in the present study: 52 patients ( 76.5%)
( 43 males, 9 females. mean age 56+11 years) received intravenous streptokinase
(SK) group A and 16 patients (23.5%) (12 males, 4 females.
mean age 58+10 years) received conventional medical treatment. A time
domain SAECG, echocardiography and Hotter monitoring were performed
at the time of hospital discharge. There was no cl(flerence between group
A and group B patients in terms of mean LV ejection fraction (EF) ( 55±8
vs 51+11, P=NS). The incidence of ventricular late potentials was 17.3%
vs 50% in group A & B respectively (P<0.01). There was significant difference
in LVEF, dyskinesia and ventricular arrhythmias between patients
with late potentials (LP) and those without. There was also significant dill
ference In LVEF, dyskinesia and SAECG data between patients who had
arrhythmic events and those who did not Thrombolysis significantly reduces
the rate of late potentials. The reduced rate of late potentials in the
present study suggests an Unproved ventricular stability after thrombolysis.
Since the risk of ventricular arrhythmia is higher in patients with late
potentials. this may partly explain the beneficial effects of thrombolysis
after Alta |
