title: Use of Extracorporeal Membrane Oxygenation to Rescue Patients With Refractory Ventricular Arrhythmia in Acute Myocardial Infarction.
abstract: Refractory ventricular arrhythmia is a serious problem in acute myocardial infarction (AMI), with an extremely high mortality rate and limited effective treatment. Extracorporeal membrane oxygenation (ECMO) is useful to rescue patients with cardiopulmonary collapse. However, little is known about whether ECMO is a potential rescue technique for patients with refractory ventricular arrhythmia in AMI.We retrospectively analyzed prospectively collected data on patients with AMI and refractory ventricular arrhythmia who underwent ECMO as rescue therapy and the bridge to revascularization from February 2001 to January 2013. Primary endpoint was mortality on index admission, and secondary endpoint was mortality on index admission or advanced brain damage at discharge.A total of 69 (62 men) patients were enrolled in this study. During the index admission, 39 patients (56.5%) met primary endpoint, and 45 patients (65.2%) met secondary endpoint, respectively. In multivariate Cox regression analysis, both the presence of profound anoxic encephalopathy and acute renal failure requiring dialysis were significant predictive factors for both primary and secondary endpoints.ECMO is a feasible rescue therapy and bridge to revascularization in patients with refractory ventricular arrhythmia in acute myocardial infarction. The presence of profound anoxic encephalopathy and acute renal failure requiring dialysis were significant prognostic factors.
authors.affiliation: From the Department of Internal Medicine (C-FY, C-KW, Y-HL); and Department of Surgery(C-HW, Y-SC, P-RT), National Taiwan University Hospital; and National Taiwan University College of Medicine, Taipei, Taiwan (Y-HL, Y-SC).
authors.forename: Chih-Fan
authors.initials: CF
authors.lastname: Yeh
authors.forename: Chih-Hsien
authors.initials: CH
authors.lastname: Wang
authors.forename: Pi-Ru
authors.initials: PR
authors.lastname: Tsai
authors.forename: Cho-Kai
authors.initials: CK
authors.lastname: Wu
authors.forename: Yen-Hung
authors.initials: YH
authors.lastname: Lin
authors.forename: Yih-Sharng
authors.initials: YS
authors.lastname: Chen
mesh_terms: D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality; D010343:Patient Admission / Q000639:trends*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome