Background : Prolonged QRS duration(QRSd) is associated with increased mortality after myocardial infarction. Studies on large post-infarction populations have proved filtered QRSd(fQRSd) to be the best SAECG parameter to identify patients with serious arrhythmic events. Angiotensin converting enzyme inhibitor reduce overall mortality and risk of sudden cardiac death in post-infarction populations. The aim of this study was to investigate the effect of early losartan therapy on the QRSd in post-infarction patients. Method: The study included 97 patients with first acute myocardial infarction(AMI). Forty eight patients (39 men and 3 women, aged 58.8 ± 13.19 years), 23 with LAD lesion, 19 with RCA lesion and 6 with LCX lesion(12 thrombolyzed, 18 Direct PTCA, 18 delayed PTCA), received early losartan therapy. The control group consisted of 49 patients (38 men and 11 women, aged 59.55 ± 11.0 years), 18 with LAD lesion, 16 with RCA lesion and 15 with LCX lesion(10 thrombolyzed, 24 Direct PTCA, 15 delayed PTCA), who did not received early losartan therapy. The ECG and SAECG was performed at admission day and 7-14 day. Result : The baseline clinical and angiographic characteristics were similar in the both groups. The fQRSd in SAECG[115(104-121)ms vs 113(107-129)ms P value=NS]and QRSd in ECG[95(86-102)ms vs 97.5(87-106.25)ms P value=NS] were not significantly different between both groups at admission. But fQRSd in SAECG[108(102-116)ms vs 115(109-126.5)ms, P value = .001] was significantly narrow in the losartan group at 7-14days. QRSd in ECG[94.5(85-102)ms vs 98(82-106)ms P value= .08] was not significantly different between both groups at 7-14days
Conclusion : Losartan treatment early after an AMI reduces the fQRSd on day 7-14 and may thus favorably affect the arrhythmogenic substrate
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