LETTER
Thrombolysis and Ventricular Tachycardia
Paul E. Nathan and
Terrence J. Sacchi
15 January 1993 | Volume 118 Issue 2 | Page 157
TO THE EDITOR:
In a recent study, Eldar and associates [1] pointed out that patients with and without primary ventricular tachycardia do not differ in their hospital course and 1-year prognosis.
What patients, if any, received thrombolytic therapy during the acute myocardial infarction? Bourke and colleagues [2] did electrophysiologic testing in 87 patients 6 to 28 days after myocardial infarction and found, compared with placebo, intravenous streptokinase substantially reduced the incidence of inducible ventricular tachycardia without similar benefit attributable to aspirin therapy.
It is not clear what significance monomorphic or polymorphic primary ventricular tachycardia have in patients who have received thrombolytic therapy compared with those who have not. Did these arrhythmias merely identify reperfusion in patients receiving lytic agents? What effect did the administration of these agents have on the true incidence of this arrhythmia in this cohort? It seems that these issues deserve further investigation.
1. Eldar M, Sievner Z, Goldbourt V, et al. Primary ventricular tachycardia in acute myocardial infarction: clinical characteristics and mortality. Ann Intern Med. 1992; 117:31-6.
2. Bourke JP, Young AA, Richards DA, Uther JB. Reduction in the incidence of inducible ventricular tachycardia after myocardial infarction by treatment with streptokinase during infarct evolution. J Am Coll Cardiol. 1990; 16:1703-10.
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