Ventricular fibrillation in acute myocardial infarction before and during primary PCI.
BACKGROUND
There are scarce and sometimes contradictory data about ventricular fibrillation (VF) during the acute phase of MI. In-hospital VF most often occurs with inferior MI, when treated with fibrinolytics. Out-of-hospital VF seems to be associated with anterior MI. We studied characteristics of patients with VF during reperfusion therapy by primary angioplasty (PCI) versus patients with VF before PCI.


METHODS
From January 1995 until December 2001, we treated 2826 patients for acute MI and reviewed clinical records of all patients who developed VF and classified the patients according to the first episode of VF: either before or during the angioplasty procedure.


RESULTS
VF developed in 219 (8%) patients. Patients with VF during reperfusion therapy (n=74, 3%) were older (p=0.03), more frequently female (0.04), less often had heart failure (p=0.04), when compared with patient with VF before PCI (n=145, 5%). Patients with VF during PCI experienced more often preinfarction angina (p=0.009) and suffered more often from inferior MI (p=0.001), when compared with patients with VF before PCI.


CONCLUSIONS
Patients with early VF before reperfusion have different characteristics when compared with patients with VF during reperfusion. Infarct location is a major determinant of timing of VF, when both groups are compared (p<0.001).
Henriques
Jose P S
JP
Department of Cardiology, Isala Klinieken, locatie Weezenlanden, Groot Wezenland 20, 8011 JW Zwolle, The Netherlands.
Gheeraert
Peter J
PJ
Ottervanger
Jan Paul
JP
de Boer
Menko-Jan
MJ
Dambrink
Jan-Henk E
JH
Gosselink
A T Marcel
AT
van 't Hof
Arnoud W J
AW
Hoorntje
Jan C A
JC
Suryapranata
Harry
H
Zijlstra
Felix
F
D015906:Angioplasty, Balloon, Coronary; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000628:therapy*; D014693:Ventricular Fibrillation / Q000453:epidemiology / Q000209:etiology*