title: Predictors of early ventricular fibrillation before reperfusion therapy for acute ST-elevation myocardial infarction.
abstract: BACKGROUND
  Early VF accounts for the majority of deaths during the acute phase of acute MI. In patients treated with fibrinolytics, in-hospital VF occurs most frequently with inferior MI. Contrariwise, out-of-hospital VF seems to be associated with anterior wall MI and preinfarction angina (preconditioning) may protect against VF.
  
  
  OBJECTIVE
  To study clinical characteristics of patients with or without VF before or during reperfusion therapy.
  
  
  METHODS
  From January 1995 until December 2001, we treated 2826 patients for acute MI and reviewed the clinical records of all patients. Patients who developed early VF were classified according to the first episode of VF: either before or during the angioplasty procedure.
  
  
  RESULTS
  VF developed in 219 (8%) patients. Early VF before reperfusion therapy (n=145, 5%) was independently related to anterior MI (RR 2.3 (95% CI 1.53-3.50), p<0.001), absence of preinfarction angina (RR 2.1 (95% CI 1.38-3.24), p=0.001) and Killip class >1 (RR 3.8 (95% CI 2.34-6.10), p<0.001). The majority of patients with VF during angioplasty (n=74, 3%) had inferior MI (61%).
  
  
  CONCLUSIONS
  Early VF before reperfusion therapy is independently associated with anterior MI, absence of preinfarction angina and Killip class >1, whereas the majority of patients with VF during angioplasty have inferior MI.
authors.forename: J P S
authors.initials: JP
authors.lastname: Henriques
authors.forename: P J
authors.initials: PJ
authors.lastname: Gheeraert
authors.forename: F
authors.initials: F
authors.lastname: Zijlstra
authors.forename: A W J
authors.initials: AW
authors.lastname: van 't Hof
authors.forename: M-J
authors.initials: MJ
authors.lastname: de Boer
authors.forename: J-H E
authors.initials: JH
authors.lastname: Dambrink
authors.forename: A T M
authors.initials: AT
authors.lastname: Gosselink
authors.forename: J C A
authors.initials: JC
authors.lastname: Hoorntje
authors.forename: J P
authors.initials: JP
authors.lastname: Ottervanger
authors.forename: H
authors.initials: H
authors.lastname: Suryapranata
keywords: angina; heart failure; myocardial infarction; preconditioning; ventricular fibrillation