Title

Twenty-five year trends (1986-2011) in hospital incidence and case-fatality rates of ventricular tachycardia and ventricular fibrillation complicating acute myocardial infarction

UMMS Affiliation

Department of Quantitative Health Sciences; Department of Medicine, Division of Cardiovascular Medicine; Department of Emergency Medicine

Publication Date

2018-11-01

Document Type

Article

Disciplines

Cardiology | Cardiovascular Diseases | Emergency Medicine | Health Services Research | Pathological Conditions, Signs and Symptoms

Abstract

BACKGROUND: Long-term trends in the incidence rates (IRs) and hospital case-fatality rates (CFRs) of ventricular tachycardia (VT) and ventricular fibrillation (VF) among patients hospitalized with acute myocardial infarction (AMI) have not been recently examined.

METHODS: We used data from 11,825 patients hospitalized with AMI at all 11 medical centers in central Massachusetts on a biennial basis between 1986 and 2011. Multivariable adjusted logistic regression modeling was used to examine trends in hospital IRs and CFRs of VT and VF complicating AMI.

RESULTS: The median age of the study population was 71 years, 57.9% were men, and 94.7% were white. The hospital IRs declined from 14.3% in 1986/1988 to 10.5% in 2009/2011 for VT and from 8.2% to 1.7% for VF. The in-hospital CFRs declined from 27.7% to 6.9% for VT and from 49.6% to 36.0% for VF between 1986/1988 and 2009/2011, respectively. The IRs of both early ( < 48 hours) and late VT and VF declined over time, with greater declines in those of late VT and VF. The incidence rates of VT declined similarly for patients with either an ST-segment elevation myocardial infarction (STEMI) or non-STEMI, whereas they only declined in those with VF and a STEMI.

CONCLUSIONS: The hospital IRs and CHRs of VT and VF complicating AMI have declined over time, likely because of changes in acute monitoring and treatment practices. Despite these encouraging trends, efforts remain needed to identify patients at risk for these serious ventricular arrhythmias so that preventive and treatment strategies might be implemented as necessary.

Keywords

UMCCTS funding

DOI of Published Version

10.1016/j.ahj.2018.10.007

Source

Am Heart J. 2018 Nov 1;208:1-10. doi: 10.1016/j.ahj.2018.10.007. [Epub ahead of print] Link to article on publisher's site

Journal/Book/Conference Title

American heart journal

Related Resources

Link to Article in PubMed

PubMed ID

30471486

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