The electrocardiographic reperfusion peak in patients with ST-elevation myocardial infarction

Abstract

Objectives. To analyse the incidence and the prognostic value of the reperfusion peak in a population of patients with AMI treated with thrombolysis. Design. Two hundred and sixty-nine patients with ST-elevation myocardial infarction treated with thrombolysis were monitored with continuous on-line vectorcardiography. Results. A reperfusion peak defined as a transiently increased ST-VM of >50 µV followed by an immediate decrease to a level lower than the starting point was seen in 112 of all 269 (42%) patients and in 111of 149 (75%) of the patients with successful ST-resolution. A reperfusion peak was an independent predictor of better prognosis both in the short- and the long term but had no implications on the prognosis in the subgroup with successful ST-resolution. Conclusion. A reperfusion peak was equally common in patients treated with thrombolysis having a successful ST-resolution as observed in studies of patients with successful primary coronary angioplasty. The reperfusion peak was associated with better prognosis and should be recognised as a possible marker of successful reperfusion but can mimic aggravated ischemia.