Heart failure & cardiomyopathiesCohort study
Clinical Impact of Arrhythmias Detected by an Implantable Cardiac Monitoring Device With Real-Time Transmission Among Patients With Early Reduced Left Ventricular Ejection Fraction After ST-Segment Elevation Acute Myocardial Infarction
- multicenter, prospective study
Authors' conclusion
The incidence and burden of ventricular arrhythmias were lower than expected. AF was associated with an increased mortality.
Study context
- Population
- Patients who survived STEMI with reduced left ventricular ejection fraction (LVEF), monitored with an implantable cardiac monitor (ICM) after dischargeenrolled (35%) of 636 with LVEF ≤40% on day 4 or later, from 3,565 patients discharged after STEMI
- Participants
- 224 patients
Main finding
As reported in the abstract
Mortality rate · median follow-up time of 3.1 years
Mortality rate
3.7 per 100 patient-years
Observational data: associations, not effects.
Further findings
Implantable cardioverter-defibrillator (ICD) implantation · 6 months
- ICD implanted
- 25 (11%)
- primary prevention
- 23
- secondary prevention
- 2
Ambulatory arrhythmias · During follow-up
- at least 1 ambulatory arrhythmia
- 119 patients (53%)
- atrial fibrillation (atrial fibrillation (AF))
- 39 (17%)
- nonsustained ventricular tachycardia
- 35 (16%)
- sinus pauses >3 seconds
- 33 (15%)
- second-or third-degree atrioventricular block
- 14 (6%)
- sustained monomorphic ventricular tachycardia/appropriate ICD therapy
- 5 (2.2%)
Incidence rates of ventricular arrhythmias
per 100 patient-years
- nonsustained ventricular tachycardia
- 5.4
- sustained monomorphic ventricular tachycardia/appropriate ICD therapy
- 0.9
Association of AF with mortality
- Only AF was independently associated with increased mortality (adjusted HR)
- 2.5; P = 0.04
Original publication
Clinical Impact of Arrhythmias Detected by an Implantable Cardiac Monitoring Device With Real-Time Transmission Among Patients With Early Reduced Left Ventricular Ejection Fraction After ST-Segment Elevation Acute Myocardial Infarction. JACC Clin Electrophysiol. Published 26 August 2026. doi:10.1016/j.jacep.2026.07.027
Summarised from the published abstract; every number is checked against it