Non-Invasive Parameters, Including a Low Left Ventricular Ejection Fraction, for Predicting Sudden Cardiac Death in Korean Post Myocardial Infarction Patients

ABSTRACT

BACKGROUND AND OBJECTIVES: According to the MADIT II criteria, a low left ventricular ejection fraction (LVEF) is one of the most important predicting factors for sudden cardiac death (SCD) in post myocardial infarction (PMI) patients, and it is a reasonable indication for ICD implantation. The aim of this study is to reveal the incidence and the prognostic value of the non-invasive parameters and whether the MADIT II criteria for ICD implantation can be applied to Korean PMI patients. SUBJECTS AND METHODS: During the period from January 2001 to June 2005, 640 PMI survivors were included in this study. The incidence of an abnormal SAECG, premature ventricular complex (PVC) counts > or = 10/hr, non-sustained ventricular tachycardia (NSVT) on ambulatory ECG and a low ( or = 10/hr and NSVT on the ambulatory ECG was 14.3% and 7.5%, respectively. 29 patients (4.9%) had a LVEF of less than 30%. Arrhythmic events occurred in 9 of the 29 patients (31%). SCD or adverse arrhythmic events occurred in 42 of the 640 patients. The percentage of patients who were using beta-blocker was lower than that in the MADIT II study group (55% vs 70%, respectively). In the adverse arrhythmic event (+) group, the percentage of beta-blocker use was significantly lower than that in the arrhythmic event (-) group (32.5% vs 58%, respectively). CONCLUSION: The MADIT II criteria and PVCs > or = 10/hr or NSVT on the ambulatory ECG can be suggested as the indications for implanting an ICD in Korean PMI patients. The use of beta-blocker is important for preventing adverse arrhythmic events.