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European Heart Journal 1984 5(4):275-281;
Copyright © 1984 by the European Society of Cardiology.
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© 1984 The European Society of Cardiology

Ventricular performance and prognosis after primary ventricular fibrillation complicating acute myocardial infarction

N. G. DEWHURST1, W. J. HANNAN and A. L. MUIR

Department of Medicine and Department of Medical Physics, University of Edinburgh Royal Infirmary, Edinburgh

Received 29 July 1983; revised 14 November 1983; .

1Address for correspondence: Dr N G Dewhurst, Department of Medicine, Royal Infirmary, Edinburgh EH3 9YW

Abstract

To examine the relationship between early arrhythmias, infarct size and prognosis, we compared 22 consecutive patients surviving acute myocardial infarction (AMI) and primary ventricular fibrillation (VF) with a control population after AMI uncomplicated by primary VF. Left ventricular ejection fraction (EF) was measured by radionuclide ventriculography before discharge from hospital. Mean EF was significantly reduced below normal following AMI with or without primary VF (normal 0.57±0.05, mean±SD; P<0.01). Mean EF was lower among patients who survived primary VF than among those with infarction uncomplicated by primary arrhythmia (0.33 ±0.12 v. 0.46 ±0.07; P<0.01). There were striking differences in EF between those patients with anterior and those with inferior infarction. Mean EF for those surviving primary VF after transmural anterior infarction (0.23±0.06) was lower than those who had primary VF after transmural inferior infarction (0.43±0.06; P<0.01J. Normal left ventricular function was seen in four individuals who developed no further complications. Recurrent primary ventricular arrhythmia was seen v only in those individuals subsequently shown to have reduced EF. Low EF (< 0-35) was seen in 12 patients with primary VF in the context of anterior infarction, five developed breakthrough ventricular arrhythmias despite therapy and in a limited follow-up period, three have died.

Key Words: Myocardial infarction • primary ventricular fibrillation • left ventricular ejection fraction


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