心室顫動(dòng)是指心室發(fā)生無(wú)序的激動(dòng)，致使心室規(guī)律有序的激動(dòng)和舒縮功能消失，其均為功能性的心臟停跳，是致死性心律失常。

    法國(guó)一項(xiàng)研究表明，心梗急性期出現(xiàn)心室顫動(dòng)（以下簡(jiǎn)稱(chēng)室顫）的患者院內(nèi)死亡風(fēng)險(xiǎn)升高，但室顫與遠(yuǎn)期全因或心源性死亡率升高并無(wú)相關(guān)性。論文11月19日在線發(fā)表于《歐洲心臟雜志》。

    此項(xiàng)前瞻性隨訪隊(duì)列研究共納入3670例心梗住院患者。依據(jù)心梗急性期是否出現(xiàn)室顫，在出院存活患者中對(duì)院內(nèi)死亡率和5年死因加以評(píng)估。心梗急性期室顫患者為11例。94.5%的患者完成了5年隨訪。

    結(jié)果顯示，室顫患者的院內(nèi)死亡率顯著升高（校正OR 7.38;P<0.001）。在3463例出院存活者中，1024例在平均52 ± 2月隨訪期間死亡。5年總體生存率為74.4%.在Cox多變量分析中，心梗急性期并發(fā)室顫與5年死亡率升高無(wú)相關(guān)性（HR 0.78）。盡管心臟復(fù)律除顫器置入率極低（1.2%），但伴和不伴室顫患者的5年死因分布并無(wú)顯著差異，尤其是心源性猝死。

    原文閱讀:

    Abstract

    AIMS: Limited data are available on long-term prognosis or causes-of-death **ysis among survivors of acute myocardial infarction （MI） according to whether or not they developed ventricular fibrillation （VF） during the acute stage of MI.

    METHODS AND RESULTS: Among 3670 MI patients hospitalized in France in 2005 and enrolled in this prospective follow-up cohort study, we assessed in-hospital mortality and 5-year cause of death among those who survived to hospital discharge, according to whether they developed VF （116 cases） or not, during the acute stage. 94.5% of patients had complete follow-up at 5 years. In-hospital mortality was significantly higher among VF patients （adjusted OR 7.38, 95% CI 4.27-12.75, P < 0.001）。 Among 3463 survivors at hospital discharge, 1024 died during a mean follow-up of 52 ± 2 months. The overall survival rate at 5 years was 74.4% （95% CI 72.8-76.0）。 In Cox multivariate **ysis, occurrence of VF during the acute phase of MI was not associated with an increased mortality at 5 years （HR 0.78, 95% CI 0.38-1.58, P = 0.21）。 The distribution of causes of death at 5 years did not statistically differ according to the presence or absence of VF, especially for sudden cardiac death （13.1% in VF group vs.12.9% in non-VF group）， despite a very low rate of implantation of cardioverter defibrillator in both groups （Overall rate 1.2%）。

    CONCLUSION: Patients developing VF in the setting of acute MI are at higher risk of in-hospital mortality. However, VF is not associated with a higher long-term all-cause or sudden cardiac death mortality.