Heart and Vessels

, Volume 34, Issue 1, pp 52–61 | Cite as

Impact of the angiographic burden on the incidence of out-of-hospital ventricular fibrillation in patients with acute myocardial infarction

  • Yoichiro Sugizaki
  • Toshiro ShinkeEmail author
  • Tomohumi Doi
  • Nobuaki Igarashi
  • Hiromasa Otake
  • Hiroyuki Kawamori
  • Ken-ichi Hirata
Original Article


Ventricular fibrillation (VF) is a catastrophic complication of spontaneous (type 1) acute myocardial infarction (AMI). This study sought to clarify the angiographic coronary characteristics related to out-of-hospital VF in AMI patients. We retrospectively reviewed 464 consecutive cases of suspicious AMI, including type 1 AMI, with or without out-of-hospital VF. In addition to patient demographics, proximal left coronary artery (LCA) disease, multivessel disease (MVD), and chronic total occlusion (CTO) were assessed via coronary angiography and compared between patients with and without out-of-hospital VF. Coronary angiography was evaluated for 74 patients with out-of-hospital VF and for 237 without. Male sex (93.2 vs. 83.1%; P = 0.036), Killip class ≥ 2 (89.2 vs. 16.5%; P < 0.001), and ST elevation myocardial infarction (83.8 vs. 66.7%; P = 0.003) were more frequent in the out-of-hospital VF group. The culprit lesions located in the proximal left coronary artery (62.2 vs. 29.5%; P < 0.001), MVD (75.7 vs. 41.8%, P < 0.001), and CTO (43.2 vs. 10.5%, P < 0.001) were more frequently observed in patients with out-of-hospital VF. Multivariate logistic regression analysis identified the culprit lesion located in the proximal LCA [odds ratio (OR) 2.86; 95% confidence interval (CI) 1.34–6.08], the presence of CTO (OR 8.52; 95% CI 3.35–21.65), and MVD (OR 3.69; 95% CI 1.57–8.65) as predictors of out-of-hospital VF. For type 1 AMI patients, advanced disease burden including the culprit lesion located in the proximal LCA and coexistence of CTO or MVD might be associated with out-of-hospital VF.


Acute myocardial infarction Chronic total occlusion Multivessel disease Out-of-hospital ventricular fibrillation 



Acute myocardial infarction


Coronary angiography


Confidence intervals


Chronic total occlusion


Extracorporeal cardiopulmonary resuscitation


Left coronary artery


Left main trunk


Left ventricular ejection fraction


Myocardial infarction


Multivessel disease


Out-of-hospital cardiac arrest


Odds ratio


Percutaneous coronary intervention


Return of spontaneous circulation


ST elevation myocardial infarction


Ventricular fibrillation



This work had no funding support.

Compliance with ethical standards

Conflicts of interest

The authors have no conflicts of interest directly relevant to the content of this article.


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Copyright information

© Springer Japan KK, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Cardiovascular Medicine, Department of Internal MedicineKobe University Graduate School of MedicineKobeJapan
  2. 2.Department of Cardiovascular MedicineKobe Red-cross HospitalKobeJapan
  3. 3.Department of Cardiovascular MedicineHyogo Emergency Medical CenterKobeJapan

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