Incidence and prognostic implications of repetitive ventricular complexes during pre-discharge bicycle ergometry after myocardial infarction

The clinical significance of repetitive ventricular complexes (RVCs) during pre-discharge bicycle ergometry after acute myocardial infarction has been assessed in 408 consecutive patients. RVCs occurred in 32 patients (8%). When compared to patients without RVCs, those with RVCs had a larger infarction, a higher prevalence of heart failure and late sustained ventricular tachycardia or fibrillation, a lower radionuclide ejection fraction and more frequent RVCs during pre-discharge 24-hour electrocardiographic monitoring. During a follow-up 30 patients died, 17 suddenly. Mortality was 15% (N = 5) in patients with RVCs during exercise test and 7% (N = 25) in those without RVCs. Sudden death occurred in only one patient with RVCs. When multivariate analysis was applied to clinical and exercise test data, RVCs during exercise did not predict cardiac mortality independent of variables related to left ventricular function, such as a history of previous myocardial infarction, persistence of heart failure in the late hospital phase and the extent of blood pressure rise during exercise test.