Abstract
Ventricular arrhythmias are potentially life threatening complications during percutaneous coronary intervention. They include ventricular premature contractions, accelerated idioventricular rhythm, ventricular tachycardia and ventricular fibrillation. A number of reasons have been attributed to the genesis of these arrhythmias including ischemic injury, reperfusion injury, patient related factors and iatrogenic causes such as excessive catheter manipulation, coronary artery dissection, coronary air embolism, contrast mediated etc. Understanding the risk factors and planning ahead, coupled with prompt management, can reduce the impact of these arrhythmias during PCI.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Luqman N, Sung RJ, Wang CL, Kuo CT. Myocardial ischemia and ventricular fibrillation: pathophysiology and clinical implications. Int J Cardiol. 2007;119:283–90.
Majidi M, Kosinski AS, Al-Khatib SM, Lemmert ME, Smolders L, van Weert A, et al. Reperfusion ventricular arrhythmia ‘bursts’ predict larger infarct size despite TIMI 3 flow restoration with primary angioplasty for anterior ST-elevation myocardial infarction. Eur Heart J. 2009;30:757–64.
Goldberg S, Greenspon AJ, Urban PL, Muza B, Berger B, Walinsky P, Maroko PR. Reperfusion arrhythmia: a marker of restoration of antegrade flow during intracoronary thrombolysis for acute myocardial infarction. Am Heart J. 1983;105:26–32.
Six AJ, Louwerenburg JH, Kingma JH, Robles de Medina EO, van Hemel NM. Predictive value of ventricular arrhythmias for patency of the infarct-related coronary artery after thrombolytic therapy. Br Heart J. 1991;66:143–6.
Heper G, Korkmaz ME, Kilic A. Reperfusion arrhythmias: are they only a marker of epicardial reperfusion or continuing myocardial ischemia after acute myocardial infarction? Angiology. 2007;58:663–70.
Wehrens XH, Doevendans PA, Ophuis TJ, Wellens HJ. A comparison of electrocardiographic changes during reperfusion of acute myocardial infarction by thrombolysis or percutaneous transluminal coronary angioplasty. Am Heart J. 2000;139:430–6.
Mehta RH, Harjai KJ, Grines L, Stone GW, Boura J, Cox D, et al. Sustained ventricular tachycardia or fibrillation in the cardiac catheterization laboratory among patients receiving primary percutaneous coronary intervention: incidence, predictors, and outcomes. J Am Coll Cardiol. 2004;43(10):1765–72.
Giglioli C, Margheri M, Valente S, Comeglio M, Lazzeri C, Romano SM, et al. The incidence and timing of major arrhythmias following successful primary angioplasty for acute myocardial infarction. Ital Heart J. 2005;6:28–34.
Hausenloy DJ, Yellon DM. Myocardial ischemia-reperfusion injury: a neglected therapeutic target. J Clin Invest. 2013;123:92–100.
Yellon DM, Hausenloy DJ. Myocardial reperfusion injury. N Engl J Med. 2007;357:1121–35.
Braunwald E, Kloner RA. Myocardial reperfusion: a double-edged sword? J Clin Invest. 1985;76:1713–9.
Piper HM, Garcia-Dorado D, Ovize M. A fresh look at reperfusion injury. Cardiovasc Res. 1998;38:291–300.
Reimer KA, Lowe JE, Rasmussen MM, Jennings RB. The wavefront phenomenon of ischemic cell death. 1. Myocardial infarct size vs duration of coronary occlusion in dogs. Circulation. 1977;56:786–94.
Avkiran M, Marber MS. Na(+)/H(+) exchange inhibitors for cardioprotective therapy: progress, problems and prospects. J Am Coll Cardiol. 2002;39:747–53.
Mehta RH, Starr AZ, Lopes RD, Tcheng JE, Farkouh ME, Reiffel J, et al. Incidence of and outcomes associated with ventricular tachycardia or fibrillation in patients undergoing primary percutaneous coronary intervention. JAMA. 2009;301:1779–89.
Wolf GL, Kraft L, Kilzer K. Contrast agents lower ventricular fibrillation threshold. Radiology. 1978;129:215–7.
Wolf GL, Mulry CS, Laski PA, Kilzer K. Changes in ventricular fibrillation threshold induced by contrast agents during acute coronary artery occlusion. Invest Radiol. 1983;18:145–8.
Arrowood JA, Mullan DF, Kline RA, Engel TR, Kowey PR. Ventricular fibrillation during coronary angiography: the precatheterization QT interval. J Electrocardiol. 1987;20:255–9.
Wolf GL, Le Veen RF, Mulry C, Kilzer K. The influence of contrast media additives upon ventricular fibrillation thresholds during coronary angiography in ischemic and normal canine hearts. Cardiovasc Intervent Radiol. 1981;4:145–7.
Pedersen HK, Jacobsen EA, Mortensen E, Refsum H. Contrast-medium-induced ventricular fibrillation: arrhythmogenic mechanisms and the role of antiarrhythmic drugs in dogs. Acad Radiol. 1995;2:1082–8.
Chalfoun N, Morady F, Chugh A, Jongnarangsin K. Painless coronary spasm causing recurrent ventricular tachycardia. Heart Rhythm. 2007;4:1471–2.
Bashour T. Cardiac rhythm disorders complicating coronary arterial spasm. Clin Cardiol. 1984;7:510–2.
Parchure N, Batchvarov V, Malik M, Camm AJ, Kaski JC. Increased QT dispersion in patients with Prinzmetal’s variant angina and cardiac arrest. Cardiovasc Res. 2001;50:379–85.
Khan M, Schmidt DH, Bajwa T, Shalev Y. Coronary air embolism: incidence, severity, and suggested approaches to treatment. Cathet Cardiovasc Diagn. 1995;36:313–8.
Kahn JK, Hartzler GO. The spectrum of symptomatic coronary air embolism during balloon angioplasty: causes, consequences, and management. Am Heart J. 1990;119:1374–7.
Yamada T, McElderry HT, Doppalapudi H, Murakami Y, Yoshida Y, Yoshida N, et al. Idiopathic ventricular arrhythmias originating from the aortic root prevalence, electrocardiographic and electrophysiologic characteristics, and results of radiofrequency catheter ablation. J Am Coll Cardiol. 2008;52:139–47.
Berger PB, Ruocco NA, Ryan TJ, Frederick MM, Podrid PJ. Incidence and significance of ventricular tachycardia and fibrillation in the absence of hypotension or heart failure in acute myocardial infarction treated with recombinant tissue-type plasminogen activator: results from the Thrombolysis in Myocardial Infarction (TIMI) phase II trial. J Am Coll Cardiol. 1993;22:1773–9.
Gacioch GM, Topol EJ. Sudden paradoxic clinical deterioration during angioplasty of the occluded right coronary artery in acute myocardial infarction. J Am Coll Cardiol. 1989;14:1202–9.
Ornato JP. The ST-segment-elevation myocardial infarction chain of survival. Circulation. 2007;116:6–9.
Hearse DJ, Tosaki A. Free radicals and reperfusion-induced arrhythmias: protection by spin trap agent PBN in the rat heart. Circ Res. 1987;60(3):375–83.
Ludman AJ, Yellon DM, Hausenloy DJ. Cardiac preconditioning for ischaemia: lost in translation. Dis Model Mech. 2010;3(1–2):35–8.
Hausenloy DJ, Baxter G, Bell R, Bøtker HE, Davidson SM, Downey J, et al. Translating novel strategies for cardioprotection: the Hatter Workshop Recommendations. Basic Res Cardiol. 2010;105:677–86.
Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC), Steg PG, James SK, Atar D, et al. ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2012;33:2569–619.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer-Verlag London
About this chapter
Cite this chapter
Rohit, S., Chitkara, K. (2016). Ventricular Tachycardia and Fibrillation. In: Lindsay, A., Chitkara, K., Di Mario, C. (eds) Complications of Percutaneous Coronary Intervention. Springer, London. https://doi.org/10.1007/978-1-4471-4959-0_12
Download citation
DOI: https://doi.org/10.1007/978-1-4471-4959-0_12
Publisher Name: Springer, London
Print ISBN: 978-1-4471-4958-3
Online ISBN: 978-1-4471-4959-0
eBook Packages: MedicineMedicine (R0)