[Electrocardiographic, clinical and prognostic evaluation of sustained ventricular tachycardia in acute and chronic ischemic heart disease]

We retrospectively evaluated 48 patients with sustained ventricular tachycardia (STV), in whom a 12 lead ECG had been recorded during arrhythmia, considering two groups: pts. with acute or subacute myocardial infarction (MI group = 15 pts.) and pts. with chronic post infarction ischemic heart disease (CPIIHD group = 33 pts.). The electrocardiographic patterns in the basal ECG and during SVT (16 SVT in the MI group, 40 in the CPIIHD group) as well as the in-hospital and long-term prognosis were evaluated. The two groups were comparable as far as mean age, site of acute or previous infarction, and baseline ECG parameters are concerned. QTc values greater than 440 msec were present in 64.5% of the cases. The ECG recording during SVT showed longer duration of QRS in CPIIHD group (171 +/- 39 msec) versus MI group (140 +/- 25 msec) (p less than 0.005). In comparison to basal ECG, Q waves in the SVT recording were in the same site (47.2%) or in a wider site (38.1%), rarely (10.9% of the cases) there was a discordance between the two tracings. In-hospital mortality was 40% (6/15 pts.) in MI group, related to severe hemodynamic impairment, 15.1% (5/33 pts.) in CPIIHD group. During the follow-up (mean 38.4 months) survival in CPIIHD group was 89.3% at 12 months, in MI group 88.9% at 12 months. In CPIIHD patients SVT was recurrent in 60.6% of the cases.(ABSTRACT TRUNCATED AT 250 WORDS)