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Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
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Thrombolytic therapy can reduce the arrhythmogenic substrate after acute myocardial infarction: a study using the

J Akiyama1, K Aonuma, A Nogami

  • 1Department of Cardiology, Yokosuka Kyosai Hospital, Kanagawa, Japan.

Japanese Circulation Journal
|December 22, 1999
PubMed

Insights

Thrombolytic therapy for acute myocardial infarction (AMI) reduces the risk of dangerous heart rhythms by improving electrical stability. This treatment helps decrease the arrhythmogenic substrate, contributing to better survival rates.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Pharmacology

Background:

  • Thrombolytic therapy is vital for acute myocardial infarction (AMI) survival, mainly by preserving left ventricular function.
  • The impact of thrombolytic therapy on the arrhythmogenic substrate post-AMI is not well understood.

Purpose of the Study:

  • To investigate the electrophysiologic effects of thrombolytic therapy on the arrhythmogenic substrate in patients with their first AMI.
  • To assess the influence of thrombolytic therapy on electrical stability and the inducibility of ventricular tachycardia.

Main Methods:

  • Signal-averaged electrocardiography (SAECG), endocardial catheter mapping, and programmed electrical stimulation were used.
  • 93 consecutive patients with their first AMI were studied, divided into those achieving early reperfusion (group 1, n=75) and those without (group 2, n=18).

Main Results:

  • SAECG abnormalities were less frequent in group 1 (11%) compared to group 2 (33%) (p<0.02).
  • Delayed endocardial electrograms were less spatially distributed and shorter in duration in group 1 (p<0.01).
  • Sustained monomorphic ventricular tachycardia was induced less often in group 1 (20%) than in group 2 (44%) (p<0.05).

Conclusions:

  • Thrombolytic therapy effectively reduces the arrhythmogenic substrate and enhances electrical stability following acute myocardial infarction.
  • The antiarrhythmic effects of thrombolytic therapy may partially explain the improved survival observed in AMI patients treated with these drugs.

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