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非ST段抬高型心肌梗死并发心室颤动和持续性室性心动过速的发生率

Incidence of Ventricular Fibrillation and Sustained Ventricular Tachycardia Complicating Non-ST Segment Elevation Myocardial Infarction.

作者信息

Schnur Asher, Rav Acha Moshe, Loutati Ranel, Perel Nimrod, Taha Louay, Zacks Netanel, Maller Tomer, Karmi Mohammad, Bayya Feras, Levi Nir, Sabouret Pierre, Fink Noam, Marmor David, Shuvy Mony, Glikson Michael, Asher Elad

机构信息

Jesselson Heart Center, Shaare Zedek Medical Center, The Eisenberg R&D Authority, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190500, Israel.

ACTION Study Group, Institut de Cardiologie, Hôpital Pitié-Salpêtrière, Sorbonne Université, 75005 Paris, France.

出版信息

J Clin Med. 2024 Apr 15;13(8):2286. doi: 10.3390/jcm13082286.

Abstract

Primary ventricular fibrillation (VF) and sustained ventricular tachycardia (VT) are potentially lethal complications in patients suffering from acute myocardial infarction (MI). In contrast with the profound data regarding the incidence and prognostic value of ventricular arrhythmias in ST elevation myocardial infarction (STEMI) patients, data regarding contemporary non-ST elevation myocardial infarction (NSTEMI) patients with ventricular arrhythmias is scarce. The aim of the current study was to investigate the incidence of VF/VT complicating NSTEMI among patients admitted to an intensive coronary care unit (ICCU). Prospective, single-center study of patients diagnosed with NSTEMI admitted to ICCU between June 2019 and December 2022. Data including demographics, presenting symptoms, comorbid conditions, and physical examination, as well as laboratory and imaging data, were analyzed. Patients were continuously monitored for arrhythmias during their admission. The study endpoint was the development of VF/sustained VT during admission. A total of 732 patients were admitted to ICCU with a diagnosis of NSTEMI. Of them, six (0.8%) patients developed VF/VT during their admission. Nevertheless, three were excluded after they were misdiagnosed with NSTEMI instead of posterior ST elevation myocardial infarction (STEMI). Hence, only three (0.4%) NSTEMI patients had VF/VT during admission. None of the patients died during 1-year follow-up. VF/VT in NSTEMI patients treated according to contemporary guidelines including early invasive strategy is rare, suggesting these patients may not need routine monitoring and ICCU setup.

摘要

原发性心室颤动(VF)和持续性室性心动过速(VT)是急性心肌梗死(MI)患者潜在的致命并发症。与关于ST段抬高型心肌梗死(STEMI)患者室性心律失常的发生率和预后价值的大量数据相比,关于当代非ST段抬高型心肌梗死(NSTEMI)合并室性心律失常患者的数据却很匮乏。本研究的目的是调查入住强化冠心病监护病房(ICCU)的NSTEMI患者中并发VF/VT的发生率。对2019年6月至2022年12月期间入住ICCU并被诊断为NSTEMI的患者进行前瞻性单中心研究。分析了包括人口统计学、症状表现、合并症、体格检查以及实验室和影像学数据在内的数据。患者在住院期间持续监测心律失常情况。研究终点是住院期间发生VF/持续性VT。共有732例患者因NSTEMI诊断入住ICCU。其中,6例(0.8%)患者在住院期间发生VF/VT。然而,有3例在被误诊为NSTEMI而非后壁ST段抬高型心肌梗死(STEMI)后被排除。因此,只有3例(0.4%)NSTEMI患者在住院期间发生VF/VT。在1年的随访期间,所有患者均未死亡。按照当代指南(包括早期侵入性策略)治疗的NSTEMI患者发生VF/VT的情况罕见,这表明这些患者可能无需常规监测和入住ICCU。

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