Effects of Combined Emergency Percutaneous Cardiopulmonary Support and Reperfusion Treatment in Patients with Refractory Ventricular Fibrillation Complicating Acute Myocardial Infarction

Object We conducted a prospective study to determine whether or not combined emergency percutaneous cardiopulmonary support (PCPS) and coronary reperfusion treatment are useful for acute myocardial infarction (MI) patients with unsynchronized electric shock-resistive ventricular fibrillation (VF). Patients and Methods Thirty-two acute MI patients who lapsed into the refractory VF were entered into the study. Group 1 consisted of 19 patients with VF outside the hospital, and Group 2 consisted of 13 patients with VF immediately after arrival at the hospital. The primary endpoint was successful reperfusion, return of spontaneous circulation and good recovery without neurologic disability. Results The infarct-related arteries showed a significant difference between Groups 1 and 2. However, the two groups had similar rates of successful reperfusion (84.6% vs 94.7%, respectively) and return of spontaneous circulation (89.5% vs 84.6%, respectively). The rates of good recovery were similarly low in both groups (5.3% vs 15.4%, respectively). Conclusion Combined emergency PCPS and reperfusion treatment produced high return of spontaneous circulation, however the neurologic outcome was low. (Internal Medicine 38: 710-716, 1999)