陈军

青岛阜外心血管病医院 18楼内科

Contemporary analysis of predictors and etiology of ventricular fibrillation during diagnostic coronary angiography.

OBJECTIVES:To assess the incidence, investigate the predictors and analyze the causes of ventricular fibrillation (VF) during coronary angiography (CA) on the condition of current techniques.METHODS:From April 2004 to January 2007, a total 22,254 patients (27,798 procedures) received CA procedures in our center; 27 patients developed VF during CA. This report was to retrospectively analyze the clinical basic characteristics, coronary angiographic characteristics and CA procedure records of these patients.RESULTS:The incidence of VF during CA was 0.097%. The incidence of VF in radial approaches and femoral approaches was 0.076% and 0.147% (p = 0.085). The VF patients had higher coronary artery bypass grafting (CABG) rates (11.1% vs 2.3%, p = 0.024) and were more likely to have a three-vessel disease (59.3% vs 31.2%, p = 0.002) and a total occlusion lesion (25.9% vs 11.1%, p = 0.014) than non-VF patients. On logistic regression analysis, three-vessel disease (OR: 2.582, 95% CI: 1.165-5.720, p = 0.019) and the history of CABG (OR: 3.959, 95% CI: 1.160-13.513, p = 0.028) were the two independent predictors of VF occurrences. Among 27 episodes of VF, 13 were ischemia-related; 11 were manipulation-related; two were contrast-related; one was hypokalemia-related; and the causes remain unclear in five episodes.CONCLUSIONS:The incidence of VF during CA is low on the condition of current techniques. The severity of coronary artery disease (CAD) is an independent predictor of VF occurrence during CA. Acute ischemia and inappropriate manipulation may be the two main causes in VF development.

2.7
3区
第一作者

Clinical cardiology 2009

Ventricular arrhythmia onset during diagnostic coronary angiography with a 5F or 4F universal catheter.

Of 18,365 patients who underwent coronary angiography with a 4F or 5F universal catheter between April 2004 and May 2007, 24 (0.131%) experienced sustained ventricular tachycardia or ventricular fibrillation during the procedure. There was no significant difference in any clinical or angiographic characteristic between patients who had a ventricular arrhythmia and those who did not. Of the 24 episodes of ventricular arrhythmia, 14 were related to catheter manipulation, 8 to ischemia, and 2 to the contrast medium, while the cause could not be clearly established in 4. The incidence of ventricular arrhythmia with a universal catheter was 0.131%, and with a preformed catheter, 0.054% (P=.72). The study shows that serious ventricular arrhythmia occurs only rarely as a complication when coronary angiography is carried out using modern techniques and that imperfect manipulation of the catheter explains most episodes.

5.9
2区
第一作者

Revista espanola de cardiologia 2008