Association of Impaired Thrombolysis In Myocardial Infarction Myocardial Perfusion Grade With Ventricular Tachycardia and Ventricular Fibrillation Following Fibrinolytic Therapy for ST-Segment Elevation Myocardial Infarction
C. Michael Gibson, MS, MD, FACC*,*,
Yuri B. Pride, MD ,
Jacqueline L. Buros, BA*,
Erin Lord, BA*,
Amy Shui, MA*,
Sabina A. Murphy, MPH*,
Duane S. Pinto, MD, FACC,
Peter J. Zimetbaum, MD, FACC,
Marc S. Sabatine, MD, MPH, FACC ,
Christopher P. Cannon, MD, FACC,
Mark E. Josephson, MD, FACC for the TIMI Study Group
* TIMI Study Group, Beth Israel Deaconess Medical Center, Boston, Massachusetts
Brigham & Women’s Hospital, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
Division of Cardiology and Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
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Figure 2 VT/VF Among Patients With TMPG 0/1/2 Compared With TMPG 3
Impaired myocardial perfusion at angiography was associated with a significantly greater incidence of ventricular tachycardia (VT) or ventricular fibrillation (VF). TMPG = Thrombolysis In Myocardial Infarction myocardial perfusion grade.
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Figure 3 VT/VF Among Subgroups
Even among patients with normal epicardial flow (Thrombolysis In Myocardial Infarction flow grade 3), impaired myocardial perfusion was associated with a significantly greater incidence of VT/VF than normal perfusion (A). Similarly, among patients with relatively preserved systolic function (left ventricular ejection fraction >35%), impaired myocardial perfusion was associated with an increased incidence of VT/VF (B). Abbreviations as in Figure 2.
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Figure 4 VT/VF Before and After Angiography
Poor myocardial perfusion was associated with a significantly greater incidence of VT/VF before (A) and after angiography (B). Abbreviations as in Figure 2.
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Figure 5 VT/VF Before and After Angiography Among Patients With Preserved Epicardial Flow
Among patients with an open artery at angiography (Thrombolysis In Myocardial Infarction flow grade 2 or 3), impaired myocardial perfusion was associated with a significantly greater incidence of VT/VF both before (A) and after angiography (B). Abbreviations as in Figure 2.
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Figure 6 VT/VF Among Patients Undergoing PCI
No significant differences were found in the incidence of VT/VF among patients who underwent percutaneous coronary intervention (PCI) compared with those who did not (A). Normal perfusion before, after, or both before and after PCI was associated with a significantly lower incidence of VT/VF than poor perfusion both before and after PCI (B). Abbreviations as in Figure 2.
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