Effects of combined emergency percutaneous cardiopulmonary support and reperfusion treatment in patients with refractory ventricular fibrillation complicating acute myocardial infarction.
OBJECTIVE
We conducted a prospective study to determine whether or not combined emergency percutaneous cardiopulmonary support (PCPS) and coronary reperfusion treatment are useful for acute myocardial infarction (MI) patients with unsynchronized electric shock-resistive ventricular fibrillation (VF).


METHODS
Thirty-two acute MI patients who lapsed into the refractory VF were entered into the study. Group 1 consisted of 19 patients with VF outside the hospital, and Group 2 consisted of 13 patients with VF immediately after arrival at the hospital. The primary endpoint was successful reperfusion, return of spontaneous circulation and good recovery without neurologic disability.


RESULTS
The infarct-related arteries showed a significant difference between Groups 1 and 2. However, the two groups had similar rates of successful reperfusion (84.6% vs 94.7%, respectively) and return of spontaneous circulation (89.5% vs 84.6%, respectively). The rates of good recovery were similarly low in both groups (5.3% vs 15.4%, respectively).


CONCLUSIONS
Combined emergency PCPS and reperfusion treatment produced high return of spontaneous circulation, however the neurologic outcome was low.
Nagao
K
K
Department of Emergency and Critical Care Medicine, Nihon University School of Medicine, Tokyo.
Hayashi
N
N
Arima
K
K
Ooiwa
K
K
Kikushima
K
K
Anazawa
T
T
Ohtsuki
J
J
Kanmatsuse
K
K
D001243:Assisted Circulation / Q000379:methods*; D016887:Cardiopulmonary Resuscitation; D017023:Coronary Angiography; D003325:Coronary Care Units; D004554:Electric Countershock; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D015425:Myocardial Reperfusion / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000209:etiology / Q000628:therapy*