Analysis of malignant arrhythmia events in ST segment elevation ventricular premature beat

Abstract

Objective To evaluate malignant arrhythmia events in patients with ST segment elevation ventricular premature beat. Methods All of 43 patients with ST segment televation ventricular premature beat ( 25 male, 18 female) were selected in this study in the Third People’s Hospital of Shaoguan from October 2000 to March 2016.Malignant arrhythmia types, basic QT interval, morphology of QRS wave obtained from ECG monitoring and Holter were analyzed. Results Thirty-four malignant arrhythmia in 43 patients (79.07%, 25 ventricular tachycardia, 6 ventricular fibrillation, 3 R on T). Totally 20 (46.51%) cases with acute myocardial infarction and 6 (13.95%) with acute myocarditis.The basic QT intervals in patients with malignant arrhythmia events were >440 ms (87.5%) and ≤440 ms (68.42%). All 34 cases were divided into QT interval normal group (n=13) and QT interval extension group (n=21). The arrhythmias in the extension group included torsade de pointes(Tdp), while in the normal group included polymorphic ventricular tachycardia (PVT), ventricular tachycardia (except Tdp). Twenty-four the fragmented QRS(fQRS) in ventricular premature beat among the 34 malignant arrhythmia patients, and 24 (70.59%) had fragmented QRS(fQRS), 58.82% were coronary heart disease (include acute myocardial infarction). In 10 patients without fQRS 11.76% had myocarditis. Conclusions Acute myocardial injury is more common in malignant arrhythmia events of ST segment elevation ventricular premature beat.The patients with the basic longer QTc interval and fQRS, have higher risk of malignant arrhythmia. Key words: Ventricular premature beat; ST segment elevation; Malignant arrhythmia