engleski

Ventricular fibrillation in acute STEMI patients treated with primary PCI

To evaluate impact of primary ventricular fibrillation (VF) on prognosis of pts suffering acute STEMI treated with primary PCI. Authors prospectively anlysed 450 consecutive pts suffering acute STEMI and treated with primary PCI. Pts were divided in two groups, VF groups of 29 pts who suffered VF during the first 24 h of pre-and in-hospital treatment and no-VF group of 421 pts who were free of VF. All relevant clinical, laboratory as well as angiography findings were noted. Pts were interviewed after 1 year for follow-up on MACE (angina pectoris, re-IM, re-PCI, CABG, CVI and death). From total of 450 pts, 6.4% suffered VF during pre-and in-hospital treatment of acute STEMI. The mortality rates during first 7 days after acute STEMI in VF and no-VF group were 31.0% and 5.9% (p<0.005). Rate of angina pectoris CCS III and IV classes during first postinfarction year in VF group was 16, 7% and in no-VF group 2.6% (p<0.05), reinfarction rates were 5.3% and 21.2% (p=0.08), mortality rates of discharged were 5.9% and 12.2% (p=0.39). A VF group analysis was made regarding the timing of VF. Pts who suffered VF after procedure (41.4%) had higher mortality rate (50.0%) than those with VF prior to PCI (13.8%, m.r. 25.0%) and those with VF during procedure (44.8%, m.r. 15.4%), the latter being the group with highest reperfusion rate (76.9% vs. 58.3% in pts suffering VF after PCI). None of pts with VF during primary PCI and with reperfusion died during in-hospital stay, while 66.7% of such pts without reperfusion did. VF is a strong predictor of early postinfarction mortality in pts treated with primary PCI. Such pts seem to have worse MACE during 1-year follow-up, but we found no difference in 1-year mortality rate when comparing such pts with those without VF episode. VF during primary PCI in which full reperfusion was achieved has no impact on in-hospital mortality.

ventricular fibrillation; primary PCI

Abstract session 6: Ventricular arrhythmias and risk stratification of patients ; 6-1