Abstract
Electrocardiographic antecedents of ventricular fibrillation and sudden death are well known. 1,2 On the other hand, events occurring at the onset of acute myocardial infarction (AMI) have rarely been reported. 3,4 We describe our findings in 4 patients who had inhospital AMI while wearing 2-channel Holter recorders. In all cases, anterior (V 3-like) and inferior (aVF-like) leads were monitored. Tapes were manually reviewed for detection of ST-segment shifts and ventricular arrhythmias (Figure 1). The number of ventricular premature complexes, time course and morphology, as well as the prematurity index (R-R′/R-R), were determined. Ventricular premature complexes were defined as frequent if they were ≥5/min, and early if their prematurity index was <0.6. 5
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