Factors influencing survival of patient with in-hospital ventricular fibrillation: experience of a single center
Factors influencing survival of patient with in-hospital ventricular fibrillation： experience of a single center

Objective To evaluate the factors influencing the outcome of patients who suffered in-hospital ventricular fibrillation (IHVF). Methods Data of patients with IHVF in a single center were collected. Clinical characteristics of patients were compared between those survived (n=112) and those died (n=94), and those with IHVF occurred in inpatient ward and in emergency center. Multiple logistic regression analysis was used to identify factors associated with survival. Results There were 206 events in the analysis. The most common underlying disease was coronary artery disease (CAD), especially acute myocardial infarction (AMI). On multiple logistic regression analysis, independent predictors for failure to survive were higher NYHA class (odds ratio 1.7,95% CI, 13-2.2, P< 0.001), lower serum potassium concentration (K+]) (odds ratio, 2.9,95% CI, 1.9-4.3, P=0.007) and adrenaline usage (odds ratio, 25,95% CI 11.5-55.1, P< 0.001). Emergency group have better NYHA class (P = 0.012), lower K+] (P < 0.001) than in inpatient ward group. Hypokalemia (serum potassium level <4.5 mmol/L) was found in all patients with AMI in emergency group. In AMI sub-group, 56.9% of IHVF events occurred within the first day after AMI, and decreasing within 2 weeks. Patients with right coronary artery as infarction related artery (IRA) often (8/9,88.9%) had bradycardia (R-R interval > 1s) before the occurrence of IHVF, while those with left anterior descending artery as IRA often showed tachycardia (R-R interval < 0.6s) (8/12,66.7%). Conclusion The most common disease causing IHVF is CAD. Keeping K+] above 4.5mmol/l could prevent on-setting IHVF, especially to AMI patients. The worse heart function is associated with higher rate of IHVF and worse prognosis .