Prospective evaluation of where reperfusion ventricular arrhythmia “bursts” fit into optimal reperfusion in STEMI Kirian van der Weg, Wichert J. Kuijt,

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Prospective evaluation of where reperfusion ventricular arrhythmia “bursts” fit into optimal reperfusion in STEMI Kirian van der Weg, Wichert J. Kuijt, Jan G.P. Tijssen, Sebastiaan C.A.M. Bekkers, Joost D.E. Haeck, Cynthia L. Green, Miguel E. Lemmert, Robbert J. de Winter, Anton P.M. Gorgels, Mitchell W. Krucoff International Journal of Cardiology Volume 195, Pages 136-142 (September 2015) DOI: 10.1016/j.ijcard.2015.05.106 Copyright © 2015 Elsevier Ireland Ltd Terms and Conditions

Fig. 1 Full disclosure format of a 24hour ambulatory recording illustrating the onset and perpetuation of a reperfusion ventricular arrhythmia burst. Green waveforms: Sinus beats still showing some ST segment elevation. Red waveforms: accelerated idioventricular rhythm interrupting the sinus rhythm. International Journal of Cardiology 2015 195, 136-142DOI: (10.1016/j.ijcard.2015.05.106) Copyright © 2015 Elsevier Ireland Ltd Terms and Conditions

Fig. 2 Example of a patient with and a patient without VA burst. Concomitantly acquired coronary angiography assessments of pre- and post-primary percutaneous coronary intervention TIMI flow grades in two study subjects (1A and 2A) with a total occlusion in the proximal left anterior descending artery proximal (LAD); continuous digital 12-lead electrocardiography monitoring for ST-segment recovery analysis with both subjects having ≥50% stable ST-segment recovery (1B and 2B); and complete beat-to-beat Holter monitoring for quantitative rhythm analysis identifying (1C) or not identifying (2C) patient-specific ventricular arrhythmia ‘bursts’ by using independent statistical outlier detection methodology. Cx, circumflex artery; LMA, left marginal artery. Note the burst versus the background VA as depicted in 1C and 2C. Reproduced with permission from Majidi et al. [5]. International Journal of Cardiology 2015 195, 136-142DOI: (10.1016/j.ijcard.2015.05.106) Copyright © 2015 Elsevier Ireland Ltd Terms and Conditions

Fig. 3 Patient selection. Patient selection of combined dataset with reasons for exclusion. TIMI=thrombolysis in myocardial infarction, CMR=cardiac magnetic resonance, PCI=percutaneous coronary intervention. International Journal of Cardiology 2015 195, 136-142DOI: (10.1016/j.ijcard.2015.05.106) Copyright © 2015 Elsevier Ireland Ltd Terms and Conditions

Fig. 4 Effect of VA burst on infarct size. Box plots with corresponding medians and quartiles displaying the effect of VA burst for (A) infarct size for total population, (B) infarct size* of non-anterior myocardial infarctions, and (C) infarct size of anterior myocardial infarctions. * significant (p<0.05). International Journal of Cardiology 2015 195, 136-142DOI: (10.1016/j.ijcard.2015.05.106) Copyright © 2015 Elsevier Ireland Ltd Terms and Conditions

Fig. 5 Effect of stable or non-ST-recovery in combination with VA burst on infarct size. Box plot with corresponding median and quartiles displaying the effect of stable ST-recovery and the presence of VA burst for infarct size. International Journal of Cardiology 2015 195, 136-142DOI: (10.1016/j.ijcard.2015.05.106) Copyright © 2015 Elsevier Ireland Ltd Terms and Conditions