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Ventricular fibrillation complicating pacemaker insertion in acute myocardial infarction
Catheterization and Cardiovascular Diagnosis
|January 1, 1982
Summary
Temporary transvenous pacing in acute myocardial infarction (MI) patients can cause ventricular fibrillation (VF). Younger patients with inferior MI, paced within 24 hours, face higher VF risk. Lidocaine may prevent this complication.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Temporary transvenous pacing is used for bradyarrhythmias in acute myocardial infarction (MI).
- Catheter manipulation during pacing can potentially trigger adverse events.
Purpose of the Study:
- To investigate the incidence and characteristics of ventricular fibrillation (VF) during temporary transvenous pacemaker insertion in acute MI patients.
- To identify risk factors associated with VF induction during this procedure.
Main Methods:
- A retrospective analysis of 101 patients with acute MI undergoing temporary transvenous pacing.
- Comparison of patient demographics, MI characteristics, and timing of intervention between those who developed VF and those who did not.
Main Results:
- Fourteen percent of patients developed VF during catheter manipulation.
- Patients who developed VF were younger, more likely to have inferior MI, and received pacing within 24 hours of symptom onset.
- Intravenous lidocaine administration and defibrillation were effective in managing VF and allowing successful catheter placement in most cases.
Conclusions:
- Temporary transvenous pacemaker insertion in acute MI carries a risk of VF, particularly in younger patients with inferior MI paced early.
- Lidocaine may be beneficial in preventing VF induction during catheter manipulation in this high-risk group.