Bertini G, Giglioli C, Margheri M, Conti A, Fattirolli F, Giuntini F, Mangialavori G, Paterni M, Daraio A
G Ital Cardiol. 1985 Feb;15(2):169-76.
In order to determinate the incidence, predictivity and prognosis of ventricular fibrillation in the early phase of acute myocardial infarction a series of 301 patients with acute myocardial infarction consecutively assisted by the Mobile Coronary Care Unit of Florence was analyzed. 151 patients (50.2%) received intensive care within 2 hours from the onset of the symptoms, 75 patients (24.9%) received intensive care between the second and sixth hour. 38 patients (12.6%) had at least one episode of ventricular fibrillation. 30% of the episodes of ventricular fibrillation happened within 1 hours from the onset of the symptoms, 47.4% within 2 hours, 74% within 6 hours. Serious arrhythmias complicated the early phase of acute myocardial infarction, but only sinus bradycardia seems to have a significant predicativity of ventricular fibrillation (P less than 0.05). We found that hospital survival resuscitated patients is strictly related to the time between early symptoms and the episode of ventricular fibrillation: 91% of the patients with ventricular fibrillation within 1 hour were discharged alive from hospital, 71% of those with ventricular fibrillation within 6 hours, 20% of those with ventricular fibrillation beyond 6 hours (P less than 0.01). The high rate and the favourable prognosis of ventricular fibrillation in the early phase of acute myocardial infarction must lead to a widespread implementation of rapid response emergency care systems away from hospital.
为了确定急性心肌梗死早期室颤的发生率、预测性和预后，对佛罗伦萨流动冠心病监护病房连续收治的301例急性心肌梗死患者进行了分析。151例患者（50.2%）在症状发作后2小时内接受了重症监护，75例患者（24.9%）在第二至第六小时接受了重症监护。38例患者（12.6%）至少发生过一次室颤。30%的室颤发作发生在症状发作后1小时内，47.4%发生在2小时内，74%发生在6小时内。严重心律失常使急性心肌梗死早期病情复杂化，但只有窦性心动过缓似乎对室颤有显著的预测性（P<0.05）。我们发现，复苏患者的院内生存率与早期症状和室颤发作之间的时间密切相关：1小时内发生室颤的患者中有91%出院存活，6小时内发生室颤的患者中有71%，6小时后发生室颤的患者中有20%（P<0.01）。急性心肌梗死早期室颤的高发生率和良好预后必然导致在医院外广泛实施快速反应急救系统。
