European Heart Journal Advance Access originally published online on September 4, 2006
European Heart Journal 2006 27(21):2499-2510; doi:10.1093/eurheartj/ehl218
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Risk factors for primary ventricular fibrillation during acute myocardial infarction: a systematic review and meta-analysis
1 Department of Cardiology, University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
2 Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands
3 Department of Public Health, Ghent University, Ghent, Belgium
Received 15 May 2006; revised 11 July 2006; accepted 17 August 2006; online publish-ahead-of-print 4 September 2006.
* Corresponding author. Tel: +32 9 240 44 05; fax: +32 9 240 49 99. E-mail address: peter.gheeraert{at}uzgent.be
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.
Key Words: Acute myocardial infarction • Meta-analysis • Primary ventricular fibrillation • Risk factors
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