INFLUENCE OF RESIDUAL BLOOD-FLOW IN THE INFARCT-RELATED ARTERY ON VENTRICULAR-TACHYCARDIA AFTER MYOCARDIAL-INFARCTION

Ventricular tachycardia (VT) late after myocardial infarction is generally attributed to reentry due to slowed conduction and heterogeneous refractoriness in surviving myocytes bordering and traversing the infarcted area.1 Thrombolytic trials and angiographic studies indicate that a patent infarct-related artery (IRA) is associated with lower sudden death mortality and that this benefit may be independent of measurable preservation of global left ventricular function.2-5 Similarly, the presence of coronary collateral circulation to nonreperfused IRAs is associated with a reduction in infarct size, and a decrease in early ventricular arrhythmias.6-8 Predictors of VT development after myocardial infarction including inducible arrhythmias at programmed electrical stimulation, 9-11 development of a left ventricular aneurysm and late potentials detected by signal-averaged electrocardiography12,13 are also favorably influenced by IRA perfusion. To determine if absence of residual IRA flow distinguishes post-myocardial infarction patients with VT, we reviewed coronary angiograms of 14 patients with recurrent VT late after myocardial infarction and 14 matched control patients. © 1992.