EVALUATION OF 24-HOUR AMBULATORY ELECTROCARDIOGRAPHIC FINDINGS FOR RISK STRATIFICATION OF PATIENTS AFTER ACUTE MYOCARDIAL INFARCTION

Background- Prognosis determination after acute myocardial infarction (AMI) is an ‎important issue; the purpose of the study was to evaluate the relation between 24-hour ‎ambulatory electrocardiography (24hr ECG) databases with 6-month cardiac events in ‎post-MI patients with low ejection fraction.
Methods- A cohort study was performed on 100 consecutive patients (62 men, 38 ‎women) with AMI and mean ejection fraction 34.94±5.23%. These patients had 24-hr ‎ECG monitoring and recordings were reviewed for ST-segment depression, complex ‎premature ventricular contractions (PVC), frequent PVCs and heart rate variability. ‎Then patients were followed for at least 6 months for readmission for cardiac causes, ‎repeat MI, sudden cardiac death (SCD) and non-sudden cardiac death. The data were ‎analyzed by multiple logistic regressions.
‎ Results- There were significant positive relationships between: 1) complex PVCs ‎‎(P<0.002) and ST depression (p<0.002) with readmission, 2) ST depression with ‎repeat MI (p<0.002), 3) reduced heart rate variability (HRV) with sudden cardiac ‎death (p<0.001), and 4) complex PVCs with non-sudden cardiac death (p<0.036).‎ ‎
‎ Conclusion- It seems that 24hr ECG may be a useful method for more risk ‎stratification of high risk patients (Iranian Heart Journal 2003; 4 (2, 3):50-54).‎