Clinical Study of Ventricular Premature Beats Detected by Ambulatory ECG Monitoring After Acute Myocardial Infarction

ABSTRACT

A 24 hour ECG monitoring was performed before hospital discharge in 19 patients who survived the hospital phase of acute myocardial infarction and follow-up 6 hour daytime ambulatory ECG monitoring was performed in 11 out of 19 patients 6 months after discharge. In predischarge ambulatory ECG monitoring, VPBs were detected in 78.9% with 26% of complex VPB s(bigeminy, multiform, salvos and R on T) and these rates were some-what decreased in follow-up study(63.6% and 19%). The mean number of VPBs was decreased in follow-up study(18.6+/-7.6/hour) than that of predischarge ECG monitoring(27.9+/-1/hour), but the premature index was similar in both studies. In patients with complex VPBs, the mean number of VPBs(93+/-17.1/hour) was greater than that of low grade VPBs(6.5+/-1.8/hour)(P<0.01) and the EPSS measured by echocardiography was greater in patient with VPBs than inpatients without VPBs(P<0.05). Inspite of using antiarrhythmic drugs such as beta-blocker and calcium channel blocker, only half of the patients improved and one-third of patients were aggravated. Sudden cardiac death was datected in one patient at 13th month after discharge who had multiple-site infarction and ventricular tachycardia.