Ventricular tachycardia or fibrillation occurred in 4.3% of patients during primary PCI and did not influence in-hospital or one-year outcomes, with lack of beta-blockers increasing risk (OR 2.34).
Cohort (n=3,065)
Does the occurrence of VT/VF during primary PCI affect in-hospital and one-year outcomes?
VT/VF during primary PCI is infrequent (4.3%) and associated with specific predictors like lack of preprocedural beta-blockers, but does not adversely affect in-hospital or one-year outcomes.
OBJECTIVES: We sought to evaluate the incidence, predictors, and outcomes of ventricular tachycardia and/or ventricular fibrillation (VT/VF) in the cardiac catheterization laboratory among patients undergoing primary percutaneous coronary intervention (PCI). BACKGROUND: Although VT/VF has been known to occur during primary PCI, the current data do not identify patients at risk for these arrhythmias or the outcomes of such patients. METHODS: We evaluated 3065 patients enrolled in the Primary Angioplasty in Myocardial Infarction (PAMI) trials, who underwent primary PCI to evaluate the associations of VT/VF and the influence of these arrhythmias on in-hospital and one-year outcomes. RESULTS: In patients undergoing primary PCI, VT/VF occurred in 133 (4.3%). Multivariate analysis identified the following as independent correlates of VT/VF: smoking (odds ratio OR 1.95, 95% confidence interval CI 1.26 to 3.02), lack of preprocedural beta-blockers (OR 2.34, 95% CI 1.35 to 4.07), time from symptom onset to emergency room of <or=180 min (OR 2.63, 95% CI 1.42 to 4.89), initial Thrombolysis In Myocardial Infarction (TIMI) flow grade 0 (OR 2.06, 95% CI 1.23 to 3.47), and right coronary artery-related infarct (OR 1.93, 95% CI 1.25 to 2.99). Although patients with VT/VF had a higher incidence of bradyarrhythmias, hypotension, cardiopulmonary resuscitation, and endotracheal intubation in the catheterization laboratory, their in-hospital and one-year adverse outcomes were similar to those of the cohort without these arrhythmias. CONCLUSIONS: Our findings suggest that the incidence of VT/VF during primary PCI is low, indicating that these arrhythmias do not influence PCI success or in-hospital or one-year outcomes. Our data further help identify patients at risk of VT/VF during primary PCI and suggest that pretreatment with beta-blockers should be strongly considered to reduce these arrhythmias.
Mehta et al. (Sat,) conducted a cohort in Myocardial infarction (n=3,065). Ventricular tachycardia and/or ventricular fibrillation (VT/VF) vs. No VT/VF was evaluated on Incidence of VT/VF. Ventricular tachycardia or fibrillation occurred in 4.3% of patients during primary PCI and did not influence in-hospital or one-year outcomes, with lack of beta-blockers increasing risk (OR 2.34).