Serial Analysis of Spontaneous and Induced Ventricular Arrhythmias in a Canine Model of Myocardial Infarction

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To study the time course of spontaneous and induced ventricular arrhythmias after myocardial infarction (MI), 20 dogs underwent ligation of the left anterior descending coronary artery and temporary occlusion and reperfusion of the obtuse marginal branch. There were 5 early deaths (<24 hours) due to spontaneous ventricular fibrillation (VF). All 15 survivors exhibited spontaneous ventricular tachycardia (VT) up to day 3 with the shortest cycle length occurring at 17 hours after MI (232±11 msec: mean±SEM). The grade of arrhythmia complexity was decreased after day 4 compared to day 1 (p=0.049), and the number of ventricular premature complexes was reduced after day 6 (1700±1390/hour) compared to day 1 (9500±640/hour, p=0.042). Serial electrophysiologic studies were carried out on days 8, 15, 22, and 29 via an implanted antitachycardia pacemaker using 1 to 3 extrastimuli and rapid ventricular pacing (RVP). On day 8, VT was inducible in 7 dogs (46%), VF in 4 (27%), and 4 dogs (27%) exhibited a negative response. On day 15, 3 more dogs became negative, and all previously negative dogs displayed negative responses. From day 15, the inducibility of VT/VF remained "constant" using RVP. However, inducibility by triple extrastimuli declined week by week until day 29. Stepwise logistic regression analysis of 20 variables selected the mass of the MI as the only independent predictor of inducible VT/VF by multiple extrastimuli and RVP after day 15 (p=0.049). Thus significant timeand modedependent changes in inducibility of VT/VF occur during the early phase after MI.