Frequency and prognostic significance of secondary ventricular fibrillation complicating acute myocardial infarction. SPRINT Study Group.
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.
Behar
S
S
Neufeld Cardiac Research Institute, Sheba Medical Center, Tel Hashomer, Israel.
Reicher-Reiss
H
H
Shechter
M
M
Rabinowitz
B
B
Kaplinsky
E
E
Abinader
E
E
Agmon
J
J
Friedman
Y
Y
Barzilai
J
J
Kauli
N
N
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*