Key result
Primary ventricular fibrillation during acute myocardial infarction was associated with ST-segment elevation on admission ECG (OR 3.35), earlier admission, male gender, and smoking.
Why the study?
Risk factors for primary ventricular fibrillation during acute myocardial infarction were not clearly established and required systematic evaluation.
Meta-Analysis (n=57,158)
Answers are grounded in this paper and cite their sources.
ST-segment elevation and shorter time from symptom onset to admission are the primary identifiable risk factors for primary ventricular fibrillation during acute myocardial infarction.
AIMS: To evaluate potential risk factors for primary ventricular fibrillation (PVF) during acute myocardial infarction (AMI) by a systematic review and meta-analyses. METHODS AND RESULTS: We searched PubMed for English articles on 'humans' published between 1964 and January 2006 using a validated combination of MESH terms. Twenty-one cohort studies describing 57 158 patients with AMI were analysed. Patients with validated PVF (n=2316) were characterized by an earlier admission (weighted mean difference -2.62 h), male gender [odds ratio (OR 1.27)], smoking (OR 1.26), absence of history of angina (OR for history of angina 0.84), lower heart rate at admission (weighted mean difference -4.02 b.p.m.), ST-segment elevation on admission ECG (OR 3.35), AV conduction block before PVF (OR 2.02), and lower serum potassium at admission (weighted mean difference -0.27 meq/L). Patients with validated PVF developed a larger enzymatic infarct size (standardized mean difference 0.74, P<0.00001). PVF was not associated with a history of myocardial infarction or hypertension. CONCLUSION: Patients who developed a validated PVF presented with characteristics of both abrupt coronary occlusion and early hospital admission. This review provides no evidence for risk factors for PVF other than ST-elevation and time from onset of symptoms. To find new risk factors, studies should compare validated PVF patients with non-PVF patients who have no signs of heart failure and comparable time delay between onset of symptoms and medical attendance.
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Gheeraert et al. (2006) conducted a meta-analysis in Acute myocardial infarction (n=57,158). Risk factors (e.g., ST-segment elevation, earlier admission) vs. Patients without primary ventricular fibrillation was evaluated on Primary ventricular fibrillation (PVF) (OR 3.35). Primary ventricular fibrillation during acute myocardial infarction was associated with ST-segment elevation on admission ECG (OR 3.35), earlier admission, male gender, and smoking.
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