Primary ventricular fibrillation
{{short description|Heart condition}}
File:Ventricular fibrillation.png
Primary ventricular fibrillation (PVF) is an unpredictable {{cite journal |vauthors=Gheeraert PJ, De Buyzere ML, Taeymans YM, Gillebert TC, Henriques JP, De Backer G, De Bacquer D |title= Risk factors for primary ventricular fibrillation during acute myocardial infarction: a systematic review and meta-analysis |journal= Eur Heart J |volume=27 |issue=21 |pages=2499–510 |year=2006|pmid=16952926 |doi= 10.1093/eurheartj/ehl218|doi-access=free }} and potentially fatal arrhythmia occurring during the acute phase of a myocardial infarction leading to immediate collapse and, if left untreated, leads to sudden cardiac death within minutes. In developed countries, PVF is a leading cause of death.{{Cite web |url=http://www.primaryventricularfibrillation.com/ |title=primaryventricularfibrillation.com |access-date=2020-05-11 |archive-url=https://web.archive.org/web/20101120022045/http://www.primaryventricularfibrillation.com/ |archive-date=2010-11-20 |url-status=dead }} Worldwide, the annual number of deaths caused by PVF is comparable to the number of deaths caused by road traffic accidents.{{cite journal |vauthors=Mathers CD, Loncar D |title= Projections of global mortality and burden of disease from 2002 to 2030|journal= PLOS Med|volume=3 |issue=11|pages=e442 |year=2006|pmid=17132052|doi= 10.1371/journal.pmed.0030442|pmc= 1664601|doi-access= free}} A substantial portion of these deaths could be avoided by seeking immediate medical attention when symptoms are noticed.
Risk factors
The risk of PVF during acute myocardial infarction is related to the amount of ST elevation, the presence of hypokalemia, the absence of pre-infarction angina, the size of the infarction, and the presence of a blocked left coronary artery. Other risk factors could include younger age, male gender, and history of sudden cardiac death in first degree relatives.
Diagnosis
=Definition=
PVF is defined as ventricular fibrillation not preceded by heart failure or shock, in contrast to secondary ventricular fibrillation, which is.{{cn|date=February 2021}}
Prognosis
After return of heart function, there has been a moderately higher risk of death in the hospital when compared to MI patients without PVF. Whether this still holds true with the recent changes in treatment strategies of earlier hospital admission and immediate angioplasty with thrombus removal is unknown. PVF does not affect the long-term prognosis.{{cite journal |vauthors=Behar S, Goldbourt U, Reicher-Reiss H, Kaplinsky E |title= Prognosis of acute myocardial infarction complicated by primary ventricular fibrillation. Principal Investigators of the SPRINT Study.|journal= Am J Cardiol |volume= 66|issue= 17|pages= 1208–11|year= 1990|pmid= 2239724|doi= 10.1016/0002-9149(90)91101-B}}{{cite journal |vauthors=Volpi A, Cavalli A, Franzosi MG, Maggioni A, Mauri F, Santoro E, Tognoni G |title= One-year prognosis of primary ventricular fibrillation complicating acute myocardial infarction. The GISSI (Gruppo Italiano per lo Studio della Streptochinasi nell'Infarto miocardico) investigators |journal= Am J Cardiol |volume= 63|issue= 17|pages= 1174–8|year= 1989|pmid= 2565684|doi= 10.1016/0002-9149(89)90174-4}}{{cite journal |vauthors=Nicod P, Gilpin E, Dittrich H, Wright M, Engler R, Rittlemeyer J, Henning H, Ross J |title= . Late clinical outcome in patients with early ventricular fibrillation after myocardial infarction |journal= J Am Coll Cardiol |volume= 11|issue=3 |pages= 464–470|year= 1988|pmid= 3343451 |doi= 10.1016/0735-1097(88)91518-5|doi-access= free }}{{cite journal |vauthors=de Jong JS, Wilde AA, Henriques JP, Dekker LR |title= Long Term Survival after First Myocardial Infarction is not Determined by the Occurrence of Ventricular Fibrillation in the Acute Phase but Family History for Sudden Death is Detrimental.|journal= Circulation |volume= II |pages= Abstract |series= 114|year= 2006|url=http://circ.ahajournals.org/cgi/content/meeting_abstract/114/18_MeetingAbstracts/II_1198-b}}
=Survival=
The survival of PVF largely depends on the promptness of defibrillation. The success rate of prompt defibrillation during monitoring is currently higher than 95%.{{cite journal |vauthors=Volpi A, Cavalli A, Santoro L, Negri E |title= Incidence and prognosis of early primary ventricular fibrillation in acute myocardial infarction--results of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI-2) database.|journal= Am J Cardiol |volume= 82|issue=3 |pages= 265–71|year= 1998|pmid= 9708651|doi= 10.1016/S0002-9149(98)00336-1}} It is estimated that the success rate decreases by 10% for each additional minute of delay.{{Citation needed|date=July 2011}}