Prediction of life-threatening arrhythmias: Multifactorial risk stratification following acute myocardial infarction

Abstract

During the last three decades great efforts have been made to stratify patients following myocardial infarction based on the assessment of residual ischemia, persistent left ventricular dysfunction, and recurrent ventricular arrhythmias. Autonomic function assessment has recently provided a new perspective in postinfarction risk stratification. However, the predictive accuracy of the commonly used invasive and noninvasive methods is low. A combination of these techniques improves their power of risk stratification. Other variables for risk stratification, such as the QT interval, remain to be fully evaluated. Modification of the value of previously established techniques should be expected in the interventional and thrombolytic era. Further study should be aimed at improving our understanding of the underlying risk mechanisms following acute myocardial infarction. This understanding is of fundamental importance since the purpose of postinfarction risk stratification is to decrease the subsequent mortality rate.