Abstract 149: Primary Ventricular Fibrillation in Patients With ST-Elevation Myocardial Infarction
Primary Ventricular Fibrillation (pVF) is the leading cause of death in patients with ST-Elevation Myocardial Infarction (STEMI) before they reach the hospital. Our objective is to assess the current incidence, associated factors and early mortality of pVF.
Methods: Prospective cohort of consecutive STEMI patients cared for by a pre-hospital emergency service (EMS) in Andalusia, from Jan2005–Dec2008. We analyzed the documented pVF episodes within the pre-hospital emergency care, either as initial rhythm or developed before in-hospital admission. Statistical analysis: Univariate and multivariate analysis.
Results: Of 3171 patients included, 248(7.8 %) of them had at least one documented pVF episode. All the episodes were treated. Early mortality in the pVF group was 71(29.5%). In the pVF group, patients are: younger (60±13 vs 64±13 years, p<0.0001), male sex (83,1% vs 74,9 p<0.016), no diabetes (28,5% vs 19,5%, p=0.004), no hypertension (53.7% vs 42,7%, p=0.001), shorter interval from onset symptoms to call EMS (58.6 vs 161.6 of median in minutes, p<0.000) and higher early mortality (29.5% vs 11.9%, p<0.0001) The pVF was associated to younger patients (OR 0.968, CI 0.957–0.979), shorter interval symptoms-call (OR 0.997, CI 0.996–0.999) and early mortality (OR 4.592, CI 3.172–6.648).
Conclusion: The incidence of pVF in STEMI remains high when testing a pre-hospital cohort. It is an early complication, the first hour complication, in younger patients and with a high early mortality. Nevertheless more than two in three patients are discharged from hospital when pVF it's treated promptly in the pre-hospital setting
- © 2010 by American Heart Association, Inc.