Abstract 13808: Difference in Clinical Characteristics About Ventricular Fibrillation Occurrence in the Early Phase of Acute Myocardial Infarction Between Patients With and Without Early Repolarization
Background: We recently showed that the presence of early repolarization (ER) increases the risk of ventricular fibrillation (VF) occurrences in the early phase of acute myocardial infarction (AMI). However, clinical characteristics of VF occurrence in the early phase of AMI between patients with and without ER were still unknown.
Methods: This study included 279 consecutive patients with AMI (69±12 years; 74 females) in whom 12-lead ECGs before the AMI onset could be evaluated. The patients were classified based on the VF occurrence 0.1 mV from baseline in at least 2 inferior or lateral leads, manifested as QRS slurring or notching.
Results: Twenty-four patients experienced an episode of VF within 48 hours after AMI onset and ER was present in 36 patients. The prevalence of a match between the location of ER and infarction area did not differ in patients with and without VF occurrence (40% vs. 38%; p=1.0). Among 243 patients without ER, peak creatine kinase level (3888±3016 U/L vs. 2174±2157 U/L; p<0.05), number of diseased coronary arteries (2.4±0.8 vs. 1.7±0.8; p<0.01), and the prevalence of male gender (100% vs. 71%; p<0.05) and right coronary culprit artery (57% vs. 33%; p<0.05) was higher in the patients with VF occurrence than in those without. On the other hand, among 34 patients with ER, there was no significant difference in peak creatine kinase level (2392±1918 U/L vs. 2626±2332 U/L; p=0.9), number of diseased coronary arteries (1.7±0.7 vs. 1.6±0.8; p=0.7), and the prevalence of male gender (90% vs. 77%; n=0.6) and right coronary culprit artery (30% vs. 35%; n=1.0) between patients with and without VF occurrence. Duration from AMI onset to admission in emergency room was earlier in patients with VF occurrence than in those without among patients with ER (146±251 minutes vs. 532±612 minutes; p<0.01) but not among patients without ER (202±209 minutes vs. 470±843 minutes; p=0.2).
Conclusion: There were significant differences in clinical characteristics of VF occurrence in the early phase of AMI between patients with and without ER. These findings may indicate the mechanism that ER provokes VF in the early phase of AMI.
- © 2013 by American Heart Association, Inc.