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European Heart Journal 1996 17(2):213-221;
Copyright © 1996 by the European Society of Cardiology.
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© 1996 The European Society of Cardiology

Ventricular fibrillation following administration of thrombolytic treatment

The EMIP experience

J.-P. Boissel*,, A. Castaigne, C. Mercier*, L. Lion*, A. Leizorovicz* and on behalf of the EMIP group{ddagger}

*Service de Pharmacologie Clinique Lyon, France
{ddagger}Hôpital Henri Mondor Créteil, France

Received 17 February 1995; accepted 4 April 1995.

Correspondence: Jean-Pierre Boissel, MD, Service de Pharmacologie Clinique, BP 3041, 69394 Lyon, Cedex 03, France

Abstract

Reperfusion-induced ventricular fibrillation has been dem onstrated in animal models of myocardial ischaemia, but no evidence exists for this in humans. The European Myocar dial Infarction Project compared the efficacy and safety of pre-hospital thrombolytic therapy with that of hospital therapy. The objective of this study was to investigate the occurrence of reperfusion-induced ventricular fibrilla tion in acute myocardial infarction patients following thrombolytic therapy.

In a double-blind multicentre trial, eligible patients were randomized to receive anistreplase at home followed by placebo in the hospital (A/P group), or placebo followed by anistreplase (P/A group). The occurrence of ventricular fibrillation, and other adverse events were recorded on specific study forms and could be attributed to defined time intervals.

The incidence of ventricular fibrillation in the A/P group was significantly higher following the pre-hospital injection than in the P/A group (2.5% vs 1.6%; P=0.021); the situation was reversed following the hospital injection (3.6% vs 5.3%; P=0.002). No relationship was found be tween this excess of ventricular fibrillation and the patients condition, with the exception of the site of the infarct.

These results suggest the existence of reperfusion-induced ventricular fibrillation in patients developing myocardial infarction who receive thrombolytic treatment.

Key Words: Ventricular fibrillation • thrombolysis • multicentre trial • controlled clinical trial • acute myocardial infarction


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