Increase of R-wave in pre-discharge ergometric test after myocardial infarction indicates advanced left ventricular injury, latent serious arrhythmias and worse prognosis

Abstract Changes in R-wave amplitude during exercise tests performed soon after myocardial infarction (15–31 days, mean 22) were analyzed in 78 men in relation to left ventricular injury (determined by 2-D echocardiography), ventricular arrhythmias (24-h Holter monitoring) and survival after myocardial infarction. It has been found that in patients with mild left ventricular injury ( n = 51, Heger index ≤ 3) the sum of the R-wave amplitude in 15 precordial leads recorded immediately after exercise decreased by 3.7 ± 10% in comparison with resting values. In the patients with major left ventricular injury ( n = 26, Heger Index > 3) the sum of R-wave amplitude after exercise increased by 12.9 ± 17.5% ( P r = 0.35, P n = 42, Lown scale 0–2) the sum of the R-wave amplitude after exercise decreased by 5 ± 18% as compared to resting values, whereas in the patients with complex arrhythmias ( n = 23, Lown scale 3–5) the sum of R-wave amplitude increased amounting to 9.9 ± 17% ( P