A Study On The Prognostic Value Of J Wave To Malignant Ventricular Atthythmia In Patients With Acute Myocardial Infarction

OBJECTIVE To evaluate the value of J wave in the prediction of malignant ventricular arrhythmia after acute myocardial infarction.METHODS ECG and clinic data were analyzed retrospectively in 130 patients with AMI, which were divided into J wave group and non J wave group on the basis of whether presence of J wave or not. First of all, the baseline characteristics between the two groups were compared. Then, analyzed the sites of AMI, the incidence of malignant ventricular arrhythmia, QT dispersion(QTd) and Tpeak-Tend interval(TpTe) between J wave group and non J wave group. The end, divided the J wave group into malignant ventricular arrhythmia subgroup and non malignant ventricular arrhythmia subgroup, compared QTd and TpTe between the two subgroups.RESULTS 1. The baseline characteristics were not significantly different between J wave group and non J wave group. 2. 16.15 percent of patients after acute myocardial infarction appeared J wave, and it was more common in the inferior myocardial infarction(52.38%vs 26.61%,P<0.05). 3. The percentage of malignant ventricular arrhythmia was significantly different between J wave group and non J wave group(28.57% vs 1.83%,P<0.01). J wave group had five patients suffering from ventricular tachycardia, and one patient suffering from ventricular fibrillation. 4. Compared with non J wave group, the value of QTd (76±19ms vs 47±19 ms,P<0.01)and TpTe (121±33 ms vs 99±26 ms,P<0.01)were apparently higher in the J wave group, also the value of TpTe in the J wave group was apparently higher than normal value (121±33 ms vs 92 ms,P<0.01). 5. In the J wave group, the value of QTd (97±15ms vs 68±13 ms,P<0.01)and TpTe (157±27ms vs 107±22 ms,P<0.01) in the patients with malignant ventricular arrhythmia were also apparently higher than the patients without malignant ventricular arrhythmia.CONCLUSION 1. J wave in electrocardiogram points out increased TDR and is an effective index in predicting malignant ventricular arrhythmia after AMI. 2. Patients with J wave which also have increased TDR are the high risk population to occur malignant ventricular arrhythmia after AMI.