[Ventricular arrhythmias in coronary heart disease. Analysis by long-term-ecg, coronary arteriography and left ventriculography (author's transl)].

A dual channel long-term-Ecg monitoring system was used to investigate arrhythmias in 90 patients undergoing diagnostic coronary arteriography. There was no significant difference of ventricular arrhythmias during an observation period of 10 hours before and after cardiac catheterization. The incidence of ventricular premature beats (VPB) was significantly higher in coronary patients than in normal controls (normal coronary arteries and normal ventriculograms) or in a group of 24 healthy soldiers. In patients with coronary artery disease (CAD) the incidence of VPB's was 82 %. There was, however, no significant correlation between the severity of CAD and the number of VPB's although patients with 3-vessel disease showed a tendency to produce more extopic beats. In contrast, patients with generalized or regional left ventricular akinesis (systolic shortening less than 15 %) showed a significantly higher number of VPB's than patients with normal or hypokinetic ventricles. In addition the analysis of qualitative criteria of ventricular arrhythmias with regard to their prognostic significance following Lown's definition showed the same close correlation with ventricular dysfunction. In the group of patients with VPB's of high incidence and prognostic importance cardiac index and ejection fraction was significantly decreased and left ventricular enddiastolic pressure significantly elevated. In conclusion, coronary patients with left ventricular akinesis are prone not only to produce congestive heart failure, but also life-threatening ventricular arrhythmias.