Relations between enzymatically estimated myocardial infarct size and early ventricular dysrhythmia

The relation between ventricular dysrhythmia during the first 20 hours after hospitalization for acute myocardial infarction and enzymatically estimated infarct size was studied prospectively. The duration of dysrhythmia was measured by the total time during which the average premature ventricular depolarization (PVC) rate was above 25 PVCs/hr. This index was significantly correlated with infarct size index (ISI) and the strength and significance of the correlation increased when patients with previous, remote myocardial infarction were excluded. An initially expected correlation between PVC frequency and average heart rate was not observed. In a subset of patients selected to include the entire range of ISI, median PVC coupling interval did not correlate with ISI or heart rate. Our results confirm the general reduction of PVC frequency with time after hospital admission. An analysis of total lidocaine administered for therapeutic purposes and dysrhythmia evaluated by retrospective computer analysis disclosed a moderately strong and significant correlation. These findings indicate that persistence and severity of ventricular dysrhythmia in the first 20 hours after hospitalization for myocardial infarction are related to enzymatically estimated infarct size.