Primary ventricular fibrillation complicating acute myocardial infarction: an assessment of predictability and prognosis

In order to identify patients with a high risk of developing primary ventricular fibrillation (PVF) following acute myocardial infarction (AMI) and to examine the prognostic significance of this arrhythmia, 46 patients who developed PVF were compared to a group of 80 patients who had AMI without PVF. A computerized, multivariate discriminant analysis identified several significant correlates of PVF. Higher rates of hypokalemia, complete left bundle branch block, 3rd-degree AV block and a lower frequency of diabetes were found in the PVF group. No difference was found with respect to the frequency of warning arrhythmias. A discriminant function constructed on the basis of the significant variables had a 4.3% false-negative rate in predicting PVF. Recurrent ventricular fibrillation occurred in nine patients, four of whom died. In-hospital mortality was significantly higher in the PVF than in the control group. As PVF is associated, in part, with treatable derangements and increased mortality, every endeavor should be made to prevent its occurrence.