CORRELATION BETWEEN VENTRICULAR ARRHYTHMI AS AND LEFT-VENTRICULAR FUNCTION AT REST AND DURING EXERCISE IN PATIENTS WITH LEFT-VENTRICULAR ANEURYSM

The results (clinical, hemodynamic, and angiographic data) of 197 pati ents with left ventricular anterior wall aneurysm were evaluated at re st and during exercise (bicycle ergometer) 6 months after the acute in farction. Using the technique of digital subtraction angiography, left ventricular volumes were estimated after injection of contrast medium into the pulmonary artery and measuring of pulmonary artery pressure. In 136 patients a programmed right ventricular stimulation was perfor med additionally. The patients were divided into the following groups: patients with (VT+) and without (VT-) ventricular arrhythmias in hist ory. Group VT- was subdivided in patients with positive (RV+) or negat ive (RV-) result of right ventricular stimulation. In group VT+ chambe r volumes were greater and ejection fraction was smaller than in group VT-. At rest the results of subgroup RV+ were similar to group VT+, b ut during exercise similar to group RV-. These results show that left ventricular function at rest and during exercise is much more impaired in patients with spontaneous and by stimulation-induced arrhythmias t han in patients without these arrhythmias. The conclusions for clinica l practice of these findings are not yet clear, concerning, for exampl e, the prophylactic use of antiarrhythmic measurements in patients wit hout spontaneous but with induced arrhythmias. Further investigations (long-term follow-ups of these patients) will be necessary.