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European Heart Journal Advance Access published online on September 4, 2006
European Heart Journal, doi:10.1093/eurheartj/ehl218
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European Heart Journal © The European Society of Cardiology 2006; all rights reserved
Received May 15, 2006
Revised July 11, 2006
Accepted August 17, 2006

Review

Risk factors for primary ventricular fibrillation during acute myocardial infarction: a systematic review and meta-analysis

Peter J. Gheeraert 1 *, Marc L. De Buyzere 1, Yves M. Taeymans 1, Thierry C. Gillebert 1, Jose P.S. Henriques 2, Guy De Backer 3, and Dirk De Bacquer 3

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

* To whom correspondence should be addressed.
Peter J. Gheeraert, E-mail: peter.gheeraert{at}uzgent.be


  Abstract

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.

Keywords: Acute myocardial infarction; Meta-analysis; Primary ventricular fibrillation; Risk factors.
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