Sixty-six patients with myocardial infarction (MI) were studied during the acute hospital phase and during the six months after hospital discharge. The clinical characteristics, location of infarction, and data from right heart catheterization were studied in an attempt to determine what factors were associated with ventricular rhythm disturbance. Those patients with serious ventricular arrhythmias (SVA) in the acute phase of infarction were found to have a significantly greater degree of myocardial dysfunction as measured by pulmonary artery and pulmonary wedge pressure than patients with more normal rhythm (p<.05). Clinical classification of patients and location of infarction were not helpful in predicting SVA during the acute infarction period. Knowledge of hemodynamic data, presence of SVA and clinical characteristics in the acute infarction period were of no value in predicting the occurrence of SVA after hospital discharge. Patients having had an acute diaphragmatic infarction were found to have a higher incidence of SVA after hospital discharge.
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Ventricular rhythm disturbances account for significant mortality in patients with acute MI. In patients surviving the first infarction, many of the eventual deaths are sudden in nature. It is suspected that these From The Cardiology Unit, Department of Medicine, University of Rochester School of Medicine and Dentistry and Strong Memorial Hospital, Rochester, New York. Supported in part by a National Heart and Lung Institute MIRU contract, NO 1 HV 81331 (Clinical Cardiac Diseases Branch) and NHLI Training Grant HL 05500, and the Genesee Valley Heart Association. Reprint requests to: Theodore L. Biddle, M.D., Cardiology Unit --Box 679, Strong Memorial Hospital, 601 Elmwood Avenue, Rochester, NY 14642.