Resuscitation from out-of-hospital ventricular fibrillation: 4 years follow-up.

In 51 months, 234 patients with out-of-hospital ventricular fibrillation (VF) were successfully resuscitated, hospitalized, and discharged home. Patients surviving an episode of primary ventricular fibrillation, that is, VF not associated with acute myocardial infarction, showed a 2-year mortality rate greater than three times that of survivors from VF associated with acute transmural infarction. Recurrent out-of-hospital VF was common, and a pattern of early recurrence was noted, with a median interval of 17 weeks in 34 documented cases. Ten patients were counted as long-term survivors from second episodes of out-of-hospital VF, one of whom survived a third episode. Coronary anatomy and ventricular function were studied in 29 survivors of primary VF. Of the 29 patients, 23 had coronary disease, considered "operable" in 17. Exercise testing and left ventricular function studies were normal or minimally abnormal in approximately half of these patients. There is an obvious need to develop effective measures to prevent primary VF, which commonly presents almost instantaneously, without prodromal symptoms.