EDITORIAL

Primary ventricular

fbrillation in acute myocardial infarction: an inherited disease? proportion VIentricular fibrillation (VF) still threatens the lives of a largeThis form of V of patients suffering from acute myocardial infarction.

VF, i.e. occurring in the setting of acute ischaemia and in the absence of heart failure and previously known as primary VF, is assumed to constitute the single most important cause of sudden cardiac death (SCD).1 The interrelation between coronary artery disease, angina pectoris and sudden death was already described in the 18th century. Only in the 1960s, when coronary care units were developed and defibrillators became available for acute treatment,2 was its clinical relevance fully appreciated and scientific research in this field advanced spectacularly. Nevertheless, the survival rate of SCD patients remains very poor: only 6% is successfully resuscitated and discharged from the hospital alive.3 Epidemiologic data Sudden cardiac death, which in a great majority of cases is due to VF, accounts for approximately 50% of cardiovascular mortality (for a review, see Zipes and Wellens'). In a recent population-based study in the Netherlands yearly incidence of SCD in persons between 18 and 75 years of age was estimated at 1 per 1000.3 The exact incidence and epidemiological characteristics of primary VF, which usually occurs at home, are virtually impossible to collect due to the fact that proper diagnosis and success of cardiopulmonary resuscitation are dependent on timely medical assistance. As a consequence, the incidence of ventricular arrhythmias in myocardial infarction patients varies widely between studies: ventricular tachycardia 3-39% and VF 4-36%. True incidence of these ventricular arrhythmias may even be higher, since patients may have succumbed before the emergency team arrived. In contrast to middle-aged VF patients, in which coronary artery disease is the single most frequent cause, in young patients (

Primary ventricular fibrillation in acute myocardial infarction: an inherited disease?

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