13th International Congress
THE "NEW FRONTIERS"
OF ARRHYTHMIAS 1998

January 24-31, 1998
Marilleva, Trento, Italy

RT-211

Non-invasive assessment of the arrhythmogenic substrate after myocardial infarction in the thrombolytic era: GISSI-3 Arrhythmias Substudy

Maurizio Del Greco, Giandomenico Nollo*, Marcello Disertori, Giampietro Sanna**, Aldo Pietro Maggioni***, on behalf of GISSI-3 Arrhythmias Substudy Investigators.
U.O. di Cardiologia, Ospedale S. Chiara, Trento, *Centro Materiali Biofisica Medica, Istituto Trentino Cultura, Trento, **Ospedale Fatebenefratelli, Milano, ***Istituto Mario Negri, Milan, Italy

Introduction

Prognosis after acute MI has improved steadily with modern treatment as thrombolytic agents, aspirin, b-adrenoceptor blockade, and ACE-inhibitors.

However considerable debate remains regarding the mechanisms by which these drugs improve outcome after MI. In the GISSI-3 trial the treatment with lisinopril started within 24 h of symptom onset and continued for 6 weeks decreased mortality and severe left ventricular dysfunction after acute MI¹. Since the demonstrated attenuation of left ventricular dilatation only in patients with larger MI² can only partly explain the effect of lisinopril on total mortality, we hypothesized that an improvement in the arrhythmogenic substrate could be one of the factors by which lisinopril
improves prognosis after MI. Thus the main aim of the study was to assess the effects of lisinopril on the main parameters exploring the arrhythmogenic substrate after acute MI. A part of these data has been previously published³.