Out of the guidelines: should an intracardiac defibrillator be implanted in patients with recurrent early ventricular fibrillation due to recurrent acute myocardial infarction?
We report the case of a patient admitted to the hospital on two different occasions, separated by a time interval of 12 years, with the same clinical picture: acute anterior myocardial infarction complicated by early ventricular fibrillation. The patient was successfully resuscitated because, in both circumstances, he was 'lucky' to arrive at hospital within a few minutes of the onset of chest pain, and to have ventricular fibrillation in the Emergency Department. The issue of intracardiac defibrillator implantation, despite this situation is not contemplated in the current guidelines (left ventricular ejection fraction was preserved), is discussed here.
Faggiano
Pompilio
P
U.O. Di Cardiologia, Spedali Civili e Cattedra di Cardiologia, Università di Brescia, Brescia, Italy. faggiano@numerica.it
Pulcini
Emanuela
E
Curnis
Antonio
A
Vizzardi
Enrico
E
Cas
Livio Dei
LD
D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D017147:Defibrillators, Implantable; D004554:Electric Countershock; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D012008:Recurrence; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D016277:Ventricular Function, Left