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Risk factors associated with ventricular fibrillation during first ST-elevation myocardial infarction: Individual

Peder Emil Warming1, Charlotte Glinge1, Veronica Dusi2

  • 1Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark.

Heart Rhythm
|August 8, 2025
PubMed

Insights

Sudden cardiac death risk factors, including family history of sudden death (SD), atrial fibrillation (AF), and anterior myocardial infarction, independently increase the likelihood of ventricular fibrillation (VF) during a first ST-elevation myocardial infarction (STEMI). These factors are additively associated with VF development.

Area of Science:

  • Cardiology
  • Clinical Electrophysiology
  • Genetics of Cardiovascular Disease

Background:

  • Sudden cardiac death (SCD) in adults is predominantly caused by ventricular fibrillation (VF) during acute myocardial ischemia.
  • Identifying risk factors for VF is crucial for predicting SCD and developing targeted interventions.

Purpose of the Study:

  • To evaluate the association of family history of sudden death (SD), prior atrial fibrillation (AF), and anterior infarct location with VF development during a first ST-elevation myocardial infarction (STEMI).

Main Methods:

  • An individual participant data meta-analysis of 3 European case-control studies was conducted.
  • Included patients were aged 18-80 years with a first STEMI, comparing those who experienced VF (cases) to those who did not (controls) before revascularization.

Main Results:

  • Analysis included 1807 cases and 2923 controls.
  • Family history of SD (OR 1.61), previous AF (OR 1.95), and anterior myocardial infarction (OR 1.55) were independently associated with increased VF risk.
  • The effect of family history was amplified by multiple SDs, AF's effect was stronger in early VF onset, and anterior infarcts' impact varied with infarct size.

Conclusions:

  • Family history of SD, history of AF, and anterior infarct location are independent and additive risk factors for VF in patients experiencing their first STEMI.
  • These findings highlight key predictors for VF in the context of acute myocardial infarction.
Abstract

Keywords:
Acute myocardial infarctionClinical risk factorsMeta-analysisSudden deathVentricular fibrillation

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