SURVIVAL AND INCIDENCE OF MYOCARDIAL-INFARCTION IN MEN WITH AMBULATORY EGG-DETECTED FREQUENT AND COMPLEX VENTRICULAR ARRHYTHMIAS - 10-YEAR FOLLOW-UP OF THE MEN BORN 1914 STUDY IN MALMO, SWEDEN

Aim To assess to what extent do frequent or complex ventricular arrhyt hmias, detected during 24 h ambulatory electrocardiographic recording (EGG), influence prognosis with regard to survival and incidence of is chaemic heart disease. Methods and results The study subjects were the 456 randomly selected men born in 1914, the population-based cohort s tudy of 1982-83, in Malmo, Sweden. The main outcome measures were tota l mortality and incidence of cardiac event (myocardial infarction and death from ischaemic heart disease). Frequent or complex ventricular a rrhythmias (Lown classes 2-5) were detected in 49% of the men with (n = 77), and in 35% of those without, a history of myocardial infarction or angina pectoris at baseline, P = 0.019. Independent of clinically evident coronary artery disease at baseline, and after adjustment for traditional atherosclerotic risk factors and use of digitalis or betab locker therapy, frequent or complex ventricular arrhythmias were assoc iated with an increased mortality from ischaemic heart disease (relati ve risk (RR), 2.1; 95% confidence interval (CI), 1.2-3.9) and an incre ased cardiac event rate (RR, 1.6; 95% CI, 1.0-2.5)). Men free from bot h ischaemic-type ST depression and frequent or complex ventricular arr hythmias (used as the control group) had the lowest ischaemic heart di sease death rate, 5.9 per 1000 person-years. The combination of ST dep ression and frequent or complex ventricular arrhythmias was associated with an ischaemic heart disease death rate of 20.9 per 1000 person-ye ars. The cardiac event rate in these two groups was 15.6 and 76.1 per 1000 person-years, respectively (adjusted RR, 2.3; CI, 1.1-4.6). Concl usions In elderly men without a history of myocardial infarction and a ngina pectoris, frequent or complex ventricular arrhythmias during amb ulatory ECG recording is associated with an increased incidence of myo cardial infarction and mortality. Men who, during ambulatory ECG recor ding, also demonstrate ST-segment depression have an even less favoura ble prognosis.