MISMATCH BETWEEN MYOCARDIAL ACCUMULATION OF I-123 MIBG AND TC-99M-MIBI AND LATE VENTRICULAR POTENTIALS IN PATIENTS AFTER MYOCARDIAL-INFARCTION - ASSOCIATION WITH THE DEVELOPMENT OF VENTRICULAR ARRHYTHMIAS

Background late ventricular potentials are widely used to predict life -threatening arrhythmias, although the predictive value is low. To imp rove prediction, we correlated the incidence of ventricular arrhythmia s with mismatches in myocardial Tc-99m-methoxyisobutylisonitrile (MIBI )/I-123-metaiodobenzylguanidine (MIBG) accumulation and late ventricul ar potentials (LP). Methods and Results Fifty patients with old myocar dial infarctions were divided into an LP-positive group (n = 19) and a n (F-negative group in = 31). On bull's-eye single photon emission com puted tomographic MIBI and MIBG images, the heart was divided into 9 s egments to evaluate the accumulation of the 2 nuclides. There was no d ifference in total defect score (TDS) for MIBI between the LP-positive and LP-negative groups. However, TDS For MIBG and differences TDS bet ween MIBI and MIBG (Delta TDS) were significantly greater in the LP-po sitive group. Conclusions The incidence of severe ventricular arrhythm ias was greater among patients with an increased Delta TDS in the LP-p ositive group. Thus the combination of these two methods may improve t he prediction of ventricular arrhythmias after myocardial infarction.