GISSI-3 was a multicentric randomised clinical trial performed to assess the efficacy of lisinopril, transdermal glyceryl trinitrate and their combination in improving survival and ventricular function after acute myocardial infarctiion (MI). In a subgroup of patients (Arrhythmias Substudy) we analysed before hospital discharge the arrhythmogenic substrate by means of Holter recording /12 327 pts), signal-averaged ECG (SAECG, 673 pts) and short-term heart rate variability (HRV, £"$ pts) analysis. Holter recordings were performed to assess the prevalence of ventricular ectopic beats (VEB) (frequency of ventricular ectopic beats per hour and/or non sustained ventricular tachycardia). SAECG was recorded to detected ventricular late potential (VLP) using several commercial devices. QRS duration (QESD), low amplitude signal duration (LAS 40) and root mean-suare-voltage (RMS40), were measured with filters set at 40-250 Hz hith and low pass frequencies. Ten minutes of one lead ECG were recorded during the morning with the patients in supine and basal conditions and simultaneously transmitted via telephonic line to the Core laboratory, for RR interval measurement and data analysis. Time and frequency domain HRV indexes (power spectral components: LF, HF. VLF, LF/HF) were neasured on 300 consecutive RR intervals. In the population of the GISSI-3 study, patients treated with lisinopril presented at six months a reduction in overall mortality and in the combined endpoint of mortality and severe ventricular disfunction as compared with the rest of the population. On the other hand the results of GISSI-3 Arrhythmias Substudy suggest that the beneficial effects of early lisinopril treatment on prognosis after acute MI are not correlated to significant changes of the arrhythmogenic substrate when evaluated before hospital discharge by 24-h Holter monitoring for VEB prevalence, SAECG for VLP detection and short-term HRV for assessment of the autonomic nervous control
Non-invasive assessment of the arrhythmogenic substrate after myocardial infarction in thrombolytic era: GISSI-3 Arrhythmias Substudy
Nollo, Giandomenico;
1998-01-01
Abstract
GISSI-3 was a multicentric randomised clinical trial performed to assess the efficacy of lisinopril, transdermal glyceryl trinitrate and their combination in improving survival and ventricular function after acute myocardial infarctiion (MI). In a subgroup of patients (Arrhythmias Substudy) we analysed before hospital discharge the arrhythmogenic substrate by means of Holter recording /12 327 pts), signal-averaged ECG (SAECG, 673 pts) and short-term heart rate variability (HRV, £"$ pts) analysis. Holter recordings were performed to assess the prevalence of ventricular ectopic beats (VEB) (frequency of ventricular ectopic beats per hour and/or non sustained ventricular tachycardia). SAECG was recorded to detected ventricular late potential (VLP) using several commercial devices. QRS duration (QESD), low amplitude signal duration (LAS 40) and root mean-suare-voltage (RMS40), were measured with filters set at 40-250 Hz hith and low pass frequencies. Ten minutes of one lead ECG were recorded during the morning with the patients in supine and basal conditions and simultaneously transmitted via telephonic line to the Core laboratory, for RR interval measurement and data analysis. Time and frequency domain HRV indexes (power spectral components: LF, HF. VLF, LF/HF) were neasured on 300 consecutive RR intervals. In the population of the GISSI-3 study, patients treated with lisinopril presented at six months a reduction in overall mortality and in the combined endpoint of mortality and severe ventricular disfunction as compared with the rest of the population. On the other hand the results of GISSI-3 Arrhythmias Substudy suggest that the beneficial effects of early lisinopril treatment on prognosis after acute MI are not correlated to significant changes of the arrhythmogenic substrate when evaluated before hospital discharge by 24-h Holter monitoring for VEB prevalence, SAECG for VLP detection and short-term HRV for assessment of the autonomic nervous controlI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
