[Ventricular tachycardia and ventricular fibrillation following myocardial infarct: determinants of prognosis and disease course].

To assess the risk of sudden death 79 patients (pts) with sustained monomorphic ventricular tachycardia (SMVT) and 37 patients with ventricular fibrillation (VF) after myocardial infarction (MI) were studied by coronary angiography, ambulatory monitoring, and programmed electrical stimulation. Mean follow-up was 28 +/- 12 months. Total mortality was significantly higher in pts with VF (13/37, 35%) than in pts with SMVT (15/79, 19%) (p less than 0.05), whereas there were no significant differences in the incidence of sudden death between pts with VF (6/37, 16%) and those with SMVT (5/79, 6%) (p = 0.09). Patients with VF had more frequent anterior and multiple MI's (33/37, 89%) than pts with SMVT (42/79, 53%) (p less than 0.05) and more often presented their arrhythmia earlier (within 2 months) after MI (23/37, 62%) than SMVT pts (28/79, 36%) (p less than 0.05). In addition, there were significant differences in mean left-ventricular ejection fraction between pts with VF (30 +/- 8%) and those with SMVT (35 +/- 12%) (p less than 0.05). Our data show that pts with VF after myocardial infarction have more severe left ventricular dysfunction and more extensive coronary disease and a somewhat higher risk of sudden death than pts with SMVT.