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Implications of Sustained Monomorphic Ventricular Tachycardia Associated with Myocardial Injury

Alan Woelfel, MD; David H. W. Wohns, MD; and James R. Foster, MD
Ann Intern Med. 1990;112(2):141-143. doi:10.7326/0003-4819-112-2-141
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Elevations of serum creatine kinase indicative of myocardial injury may be detected occasionally in patients who present with sustained monomorphic ventricular tachycardia. However, the implications of this finding with respect to subsequent susceptibility to ventricular tachycardia and the need for chronic antiarrhythmic therapy are uncertain. If ventricular tachycardia occurs only as a transient consequence of the acute phase of myocardial infarction, then long-term antiarrhythmic therapy is unnecessary, as is the case for patients who have ventricular fibrillation within the first 24 hours after acute infarction (1, 2). Alternatively, if ventricular tachycardia arises from a stable, pre-existing arrhythmogenic substrate, then recurrent


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