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Updated: Aug 15, 2026
Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction
Published on: October 14, 2016
Ventricular fibrillation in acute myocardial infarction before and during primary PCI
Jose P S Henriques1, Peter J Gheeraert, Jan Paul Ottervanger
1Department of Cardiology, Isala Klinieken, locatie Weezenlanden, Groot Wezenland 20, 8011 JW Zwolle, The Netherlands.
Background:
There are scarce and sometimes contradictory data about ventricular fibrillation (VF) during the acute phase of MI. In-hospital VF most often occurs with inferior MI, when treated with fibrinolytics. Out-of-hospital VF seems to be associated with anterior MI. We studied characteristics of patients with VF during reperfusion therapy by primary angioplasty (PCI) versus patients with VF before PCI.
Methods:
From January 1995 until December 2001, we treated 2826 patients for acute MI and reviewed clinical records of all patients who developed VF and classified the patients according to the first episode of VF: either before or during the angioplasty procedure.
Results:
VF developed in 219 (8%) patients. Patients with VF during reperfusion therapy (n=74, 3%) were older (p=0.03), more frequently female (0.04), less often had heart failure (p=0.04), when compared with patient with VF before PCI (n=145, 5%). Patients with VF during PCI experienced more often preinfarction angina (p=0.009) and suffered more often from inferior MI (p=0.001), when compared with patients with VF before PCI.
Conclusions:
Patients with early VF before reperfusion have different characteristics when compared with patients with VF during reperfusion. Infarct location is a major determinant of timing of VF, when both groups are compared (p<0.001).
Insights
Ventricular fibrillation (VF) timing in acute myocardial infarction (MI) differs. Early VF before reperfusion therapy is linked to different patient profiles and infarct locations compared to VF during primary angioplasty (PCI).
Area of Science:
- Cardiology
- Emergency Medicine
- Clinical Research
Background:
- Limited and conflicting data exist on ventricular fibrillation (VF) during acute myocardial infarction (MI).
- In-hospital VF is often associated with inferior MI and fibrinolytic therapy.
- Out-of-hospital VF appears linked to anterior MI.
Purpose of the Study:
- To investigate the characteristics of patients experiencing VF during reperfusion therapy via primary angioplasty (PCI).
- To compare these patients with those experiencing VF before PCI.
Main Methods:
- Retrospective review of 2826 acute MI patients treated between January 1995 and December 2001.
- Classification of VF episodes as occurring either before or during the PCI procedure.
- Analysis of patient demographics, clinical presentation, and infarct characteristics.
Main Results:
- VF occurred in 219 (8%) of MI patients.
- Patients with VF during PCI (n=74) were older, more frequently female, and less likely to have heart failure compared to those with VF before PCI (n=145).
- VF during PCI was associated with more preinfarction angina and a higher incidence of inferior MI.
Conclusions:
- Patient characteristics differ significantly between early VF (before reperfusion) and VF during reperfusion.
- Infarct location is a critical factor influencing the timing of VF occurrence in acute MI patients undergoing PCI.
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