title: Frequency and prognostic significance of secondary ventricular fibrillation complicating acute myocardial infarction. SPRINT Study Group.
abstract: The incidence of secondary ventricular fibrillation (VF) complicating acute myocardial infarction (AMI) was 2.4% in a large cohort of unselected patients with AMI (142 of 5,839). Secondary VF was more frequent in patients with recurrent AMI (4%) than in those with a first AMI (1.9%) (p < 0.01). The hospital course was more complicated and in-hospital mortality was significantly higher in patients with secondary VF than in those with the same clinical hemodynamic condition but without VF (56 vs 16%; p < 0.0001). Multivariate analyses confirmed secondary VF complicating AMI as an independent predictor of high in-hospital mortality, with an odds ratio of 7 (95% confidence interval 4.6-10.6). However, long-term mortality after discharge (mean follow-up 5.5 years) was not increased in patients with as compared with those without secondary VF (39 vs 42%). These findings were also true when patients receiving beta blockers and antiarrhythmic therapy were excluded from analysis. Thus, this life-threatening arrhythmia occurring during hospitalization is not a marker of recurrent susceptibility to VF or an indicator of increased mortality after discharge from the hospital.
authors.affiliation: Neufeld Cardiac Research Institute, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: S
authors.initials: S
authors.lastname: Behar
authors.forename: H
authors.initials: H
authors.lastname: Reicher-Reiss
authors.forename: M
authors.initials: M
authors.lastname: Shechter
authors.forename: B
authors.initials: B
authors.lastname: Rabinowitz
authors.forename: E
authors.initials: E
authors.lastname: Kaplinsky
authors.forename: E
authors.initials: E
authors.lastname: Abinader
authors.forename: J
authors.initials: J
authors.lastname: Agmon
authors.forename: Y
authors.initials: Y
authors.lastname: Friedman
authors.forename: J
authors.initials: J
authors.lastname: Barzilai
authors.forename: N
authors.initials: N
authors.lastname: Kauli
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D008297:Male; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications*; D011379:Prognosis; D012008:Recurrence; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000453:epidemiology* / Q000209:etiology*