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33rd International Congress on Electrocardiology

International Society of Electrocardiology

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Invisible Negative Sequence Voltages Before Spontaneous Ventricular Tachyarrhythmia In Patients With Acute Myocardial Infarction

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  • corresponding author presenting/speaker W. Carson - National Taiwan University, Taipei, Taiwan
  • Y.-Z. Tseng - National Taiwan University, Taipei, Taiwan

33rd International Congress on Electrocardiology. Cologne, 28.06.-01.07.2006. Düsseldorf, Köln: German Medical Science; 2007. Doc06ice117

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/ice2006/06ice117.shtml

Published: February 8, 2007

© 2007 Carson et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

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Question: Study (Am J Emerg Med 2003) of patients with acute aortic dissection (AAD) has found that abnormal sense of inscription direction (ASID) and L/W ratio of the T-loop in the emergency vectorcardiogram (VCG), are at high risk of post-operationally unexpected ventricular tachyarrhythmia (UVT). A further study (IJBEM 2003) of the P-loop found that the ASID had partial negative sequence (PNS) or complete negative sequence (CNS) type similar to the Physics problem of generators. Can patients with acute myocardial infarction (AMI) develop UVT in the same way as patients with AAD?

Method Used: A total of 121 patients with suspected AMI received serial recording of Frank VCG.

Results: Among them 25(21%) developed UVT. Seven had no VCG before their UVT and cardioversion. The remaining 18 patients, 13 (72%, 1 PNS, 2 PNS+CNS, and 10 CNS ) had the same abnormalities of the T-loop as the AAD patients; four had partial and one had no abnormality because the time gap between VCG and UVT was too wide (between 4-22 days).

Conclusion: Therefore, in AMI patients, once emergency VCG is documented as PNS or CNS of the T-loop with an abnormal L/W ratio, then Cardiologists should be stand by for UVT attack.