[Impact of a percutaneous transluminal coronary angioplasty on the prevalence of ventricular late potentials among patients with survived myocardial infarction]

Abstract

The aim of the study was to evaluate whether a causal antiischemic intervention as percutaneous transluminal coronary angioplasty (PTCA) leads to a reduction of ventricular late potentials in the chronic post myocardial infarction period. In 24 patients, signal-averaged electrocardiograms (SAECG) for two groups were recorded for the analysis of ventricular late potentials (LP) before and after 6.0+/-4.2 months (group A, with PTCA) and 6.2+/-5.2 months, respectively (group B, conservative therapy). All patients presented prior myocardial infarction. LP were defined present if two of the three time domain criteria were met. In the whole study group, LP were positive in 73%. In group A, a PTCA was performed one month after the initial SAECG measurement. In group A, the presence of ventricular late potentials was significantly reduced (64% vs. 18%), whereas in group B only a slight decline of late potentials could be observed (85% vs. 62%). The parameters of the signal averaged ECG varied significantly in group A before and after PTCA (QRS 113.04+/-13.65 vs. 100.55+/-6.97 ms (p<0.05), RMS 24.04+/-24.13 vs. 35.39+/-16.89 muV (p=n.s.), LAS 41.23+/-13.27 vs. 29.68+/-6.47 ms (p<0.05)). The results in group B were not altered significantly.In conclusion, these results show that a PTCA of the infarct-related artery can lead to a reduction in ventricular late potentials in patients with significant coronary artery disease, who are also in the chronic post myocardial infarction period. Whether it is possible to improve the prognosis of these patients has also to be shown in future studies.