Electrocardiographic factors playing a role in ischemic ventricular fibrillation in ST elevation myocardial infarction are related to the culprit artery
Abstract
Background Sudden cardiac death caused by ischemic ventricular fibrillation (VF) associated with ST elevation myocardial infarction (STEMI) is one of the most frequent causes of death.Objective We hypothesized that electrocardiographic (ECG) characteristics differ between STEMI patients with and without ischemic VF.Methods Fifty-five first STEMI patients with at least one 12-lead ECG recorded before ischemic VF were compared with 110 first STEMI patients without ischemic VF. Patients with bundle branch blocks or high-degree atrioventricular blocks with escape rhythms were not included. ECG measurements were performed manually after scanning the ECG with the most prominent ST deviation into a software environment and magnifying it 4 times.Results Mean age was 57 +/- 12 years, and 126 patients were male. No differences were present between the VF and control group regarding baseline, enzymatic, and angiographic data. In left circumflex artery and right coronary artery myocardial infarction, a longer QRS interval (109 +/- 23 ms vs. 91 +/- 16 ms, P = .02 and 107 +/- 24 ms vs. 93 +/- 19, P = .02) was present. In the latter the PR interval (211 +/- 64 ms vs. 160 +/- 36 ms, P <.001) and ST deviation score (3.6 +/- 1.0 mV vs. 1.7 +/- 1.5 mV, P <.001) were also increased. In the left anterior descending artery group no differences in conduction intervals and ST deviation score were present.Conclusion Longer PR and QRS intervals in right coronary artery and left circumflex artery MI fit with the perfusion and activation pattern of the atrioventricular node and the ventricular myocardium. Myocardium perfused by the left anterior descending artery is activated earliest, hiding any intraventricular conduction delay within the QRS complex. Intramural slowed conduction could be a substrate for ischemic VF.
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In patients with ischemic ventricular fibrillation in ST elevation myocardial infarction, longer PR and QRS intervals were found and intramural slowed conduction was proposed as a substrate.
“in these patients a longer PR and QRS intervals were found and intramural slowed conduction was proposed to be a substrate to the ventricular fibrillation.17”
From The Year of 2008 in Electrocardiology (2010) · cites this paper as [17]
Ischemic ventricular fibrillation in ST elevation myocardial infarction could be related to the culprit artery being the right coronary and left circumflex arteries.
“Ischemic ventricular fibrillation in ST elevation myocardial infarction could be related to the culprit artery being the right coronary and left cicumflex arteries; in these patients a longer PR and QRS intervals were found and intramural slowed conduction was proposed to be a substrate to the ventricular fibrillation.17”
From The Year of 2008 in Electrocardiology (2010) · cites this paper as [17]
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The Year of 2008 in Electrocardiology
Stern, S. (2010) · Annals of Noninvasive Electrocardiology · doi:10.1111/j.1542-474x.2009.00347.x · Cited by 1 · see citing works
- Authors
- Lemmert, M. E., de Jong, J. S. S. G., van Stipdonk, A. M. W., Crijns, H. J. G. M., Wellens, H. J. J., Krucoff, M. W., Dekker, L. R., Wilde, A. A. M., & Gorgels, A. P. M.
- Affiliations
- Maastricht University Medical Centre (NL)
- Duke University (US)
- Amsterdam UMC Location University of Amsterdam (NL)
- Corresponding author
- Lemmert, Miguel E.
- Venue
- Heart Rhythm
- Publisher
- Elsevier BV
- Published
- 2008-01
- Volume
- 5
- Issue
- 1
- Pages
- 71-78
- ISSN
- 1547-5271 (ISSN-L)
- OpenAlex
- W2080632332
- Cited by
- 31
- References
- 22
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 2 · 2022: 3 · 2021: 2 · 2020: 2 · 2019: 2 · 2017: 2 · 2016: 1 · 2015: 1 · 2013: 2 · 2012: 4
- FWCI
- 1.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Heart Rhythm (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Pathology and Forensic Medicine › Cardiac Ischemia and Reperfusion
- Keywords
- ST-elevation myocardial infarction, electrocardiographic predictors, infarct-related artery, right coronary artery infarction, left anterior descending artery infarction, QRS duration, PR interval, atrioventricular conduction delay, sudden cardiac death, atrioventricular node
- MeSH terms
- Coronary Vessels, Electrocardiography, Heart Conduction System, Humans, Male, Middle Aged, Myocardial Infarction, Retrospective Studies, Tachycardia, Ventricular Fibrillation, Case-Control Studies, Myocardial Ischemia
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