Discrimination between subsequent sudden and non-sudden death by postinfarction exercise testing.

Abstract

An analysis was made of differences in response to postinfarction exercise testing between patients with subsequent sudden and non-sudden death occurring during a 6-year follow-up period after acute myocardial infarction. In the 21 patients who died suddenly the ST-segment depression appeared earlier during exercise and was greater at the end of exercise than in those 25 patients whose death was not sudden (p-values less than 0.025). The physical working capacity of the sudden death group was insignificantly better and the work was performed with an insignificantly higher heart rate and lower systolic blood pressure than in the other group. The heart rate-blood pressure product during maximal work load was the same in both groups. The T-wave depression and P-terminal force negativity after exercise were greater in the sudden death group than in the non-sudden death group (p-values less than 0.025, less than 0.001, respectively). Ventricular ectopic beats, especially after exercise, were also more common in the sudden death group.