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[Late potentials in patients with myocardial infarction subjected to coronary thrombolysis]
G Bellotti1, B Tranchesi, P Moffa
1Instituto do Coração do Hospital das Clínicas-FMUSP.
Insights
Successful thrombolysis significantly reduced late potentials (LP) in acute myocardial infarction patients. This finding suggests recanalization impacts cardiac electrical activity, though further research is needed for full clinical significance.
Area of Science:
- Cardiology
- Electrophysiology
- Myocardial Infarction Research
Purpose:
Analyse the behavior of the late potentials (LP) in patients submitted to thrombolysis with success.
Material And Methods:
Thirty-five patients with acute myocardial infarction, 32 (91.4%) male with ages varying from 33 to 68 (mean 52.6). Thrombolysis was obtained during cinecoronarography with intravenous infusion "in bolus" of doses of 50 mg, 60 mg and 70 mg of rt-PA, with a new bolus of 30 mg at 60 minutes after the procedure. A new angiographic study was performed 12-48 hours late. The high resolution ECG was taken with the ART system model 1200 EPX, before, after and 72 hours later. The presence of electrical activity in the last 40 ms of the QRS complex with less than 20 mu volts in amplitude and more than 35 ms in duration characterized the LP.
Results:
LP was observed in 16 (46%) patients during the phase of arterial occlusion. LP was recorded only in 23% after recanalization and in 26% when the infarcted related artery (IRA) remain opened. The reduction in the LP was 43.5%. Only one patient with LP had threatening arrhythmia.
Conclusion:
In patients with demonstrated thrombotic occlusion of the IRA, the recanalization diminished the incidence of LP in 43.5% of the patients. Further studies are necessary to achieve the exact clinical importance of these findings.