Ventricular tachyarrhythmias in prinzmetal's variant angina: Clinical significance and relation to the degree and time course of S-T segment elevation

Mario Previtali, Catherine Klersy, Jorge A. Salerno, Marcello Chimienti, Claudio Panciroli, Egidio Marangoni, Giuseppe Specchia, Mario Comolli, Piero Bobba

Research output: Contribution to journalArticle

Abstract

Fifty-six patients with active Prinzmetal's variant angina were studied to determine the incidence and clinical significance of ventricular tachyarrhythmias and the correlation between arrhythmias and degree and time course of S-T segment changes during the ischemic attacks. Twenty-nine patients (Group I) had no ventricular arrhythmias in any of the 1,083 recorded episodes, while 27 patients (Group II) developed arrhythmias in 18% of the attacks. No significant differences in clinical, electrocardiographic, angiographic, or hemodynamic findings could be found between the 2 groups. In 23 of the 27 Group II patients, ventricular arrhythmias developed during maximal S-T segment elevation (occlusion arrhythmias), while in 10 they occurred during resolution of S-T segment changes (reperfusion arrhythmias); 6 of the latter patients also had occlusion arrhythmias. Eight of the 23 patients with occlusion arrhythmias and 6 of the 10 with reperfusion arrhythmias had ventricular fibrillation or ventricular tachycardia. Maximal S-T segment elevation was significantly greater (p <0.001) in patients with occlusion arrhythmias than in those without arrhythmias. The episodes with reperfusion arrhythmias were significantly longer (p <0.001) and showed a significantly greater S-T segment elevation (p <0.001) than those without arrhythmias in Group I patients. This study shows that significant ventricular tachyarrhythmias develop during ischemic attacks in about 50% of patients with active variant angina; clinical and angiographic features are not useful in distinguishing patients with arrhythmias from the others. Our findings suggest that in variant angina ventricular arrhythmias may be due to the effects of both coronary artery occlusion and reperfusion; both types of arrhythmias are correlated with the severity of ischemia, as measured by the degree of S-T segment elevation. Reperfusion arrhythmias also appear to be correlated with the duration of ischemia.

Original languageEnglish
Pages (from-to)19-25
Number of pages7
JournalThe American Journal of Cardiology
Volume52
Issue number1
DOIs
Publication statusPublished - 1983

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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