Ventricular Tachycardia or Fibrillation and ST-Segment-Elevation MI: Does Percutaneous Coronary Intervention Improve Outcomes?

According to conventional wisdom, ventricular tachychardia or fibrillation (VT/VF) in the first 48 hours after an ST-segment-elevation MI signifies poor short- and long-term prognoses, and VT/VF occurring >48 hours after MI indicates increased arrhythmic risk. However, these suppositions are derived largely from thrombolytic trials. To find out whether they still hold true now that MI is usually treated with percutaneous coronary intervention, investigators conducted a post hoc analysis of data from the APEX AMI trial of pexelizumab versus placebo in 5745 PCI-treated STEMI patients.

VT/VF occurred in 329 patients (5.7%); 90% of these events occurred within 48 hours after MI. Patients who experienced VT/VF had worse prognostic indicators than…