Usefulness of silent subendocardial ischemia detected by ST-segment depression in postmyocardial infarction patients as a predictor of ventricular arrhythmias

There is conclusive experimental and clinical evidence that severe, transmural and persistent acute ischemia (silent or symptomatic), the maximum exponent of which is myocardial infarction, can trigger malignant ventricular arrhythmias and sudden cardiac death.1 Furthermore, a relation between severe acute transmural but transient ischemia appearing during Prinzmetal's angina2 or during percutaneous transluminal angioplasty3 and ventricular arrhythmias is well known, although such arrhythmias are rarely malignant. However, the relation between ventricular arrhythmias and subendocardial ischemia (silent or symptomatic) has only been partially studied, and results are contradictory.4-7. © 1992.