Contemporary analysis of predictors and etiology of ventricular fibrillation during diagnostic coronary angiography.
OBJECTIVE
To assess the incidence, investigate the predictors and analyze the causes of ventricular fibrillation (VF) during coronary angiography (CA) on the condition of current techniques.


METHODS
From April 2004 to January 2007, a total 22,254 patients (27,798 procedures) received CA procedures in our center; 27 patients developed VF during CA. This report was to retrospectively analyze the clinical basic characteristics, coronary angiographic characteristics and CA procedure records of these patients.


RESULTS
The incidence of VF during CA was 0.097%. The incidence of VF in radial approaches and femoral approaches was 0.076% and 0.147% (p = 0.085). The VF patients had higher coronary artery bypass grafting (CABG) rates (11.1% vs 2.3%, p = 0.024) and were more likely to have a three-vessel disease (59.3% vs 31.2%, p = 0.002) and a total occlusion lesion (25.9% vs 11.1%, p = 0.014) than non-VF patients. On logistic regression analysis, three-vessel disease (OR: 2.582, 95% CI: 1.165-5.720, p = 0.019) and the history of CABG (OR: 3.959, 95% CI: 1.160-13.513, p = 0.028) were the two independent predictors of VF occurrences. Among 27 episodes of VF, 13 were ischemia-related; 11 were manipulation-related; two were contrast-related; one was hypokalemia-related; and the causes remain unclear in five episodes.


CONCLUSIONS
The incidence of VF during CA is low on the condition of current techniques. The severity of coronary artery disease (CAD) is an independent predictor of VF occurrence during CA. Acute ischemia and inappropriate manipulation may be the two main causes in VF development.
Chen
Jun
J
Department of Cardiology, Fuwai Hospital and Cardiovascular Institute, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Gao
Li-Jian
LJ
Chen
Ji-Lin
JL
Song
Hui-Jun
HJ
D016001:Confidence Intervals; D017023:Coronary Angiography / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications* / Q000503:physiopathology; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology