心室颤动是指心室发生无序的激动，致使心室规律有序的激动和舒缩功能消失，其均为功能性的心脏停跳，是致死性心律失常。

    法国一项研究表明，心梗急性期出现心室颤动（以下简称室颤）的患者院内死亡风险升高，但室颤与远期全因或心源性死亡率升高并无相关性。论文11月19日在线发表于《欧洲心脏杂志》。

    此项前瞻性随访队列研究共纳入3670例心梗住院患者。依据心梗急性期是否出现室颤，在出院存活患者中对院内死亡率和5年死因加以评估。心梗急性期室颤患者为11例。94.5%的患者完成了5年随访。

    结果显示，室颤患者的院内死亡率显著升高（校正OR 7.38;P<0.001）。在3463例出院存活者中，1024例在平均52 ± 2月随访期间死亡。5年总体生存率为74.4%.在Cox多变量分析中，心梗急性期并发室颤与5年死亡率升高无相关性（HR 0.78）。尽管心脏复律除颤器置入率极低（1.2%），但伴和不伴室颤患者的5年死因分布并无显著差异，尤其是心源性猝死。

    原文阅读:

    Abstract

    AIMS: Limited data are available on long-term prognosis or causes-of-death **ysis among survivors of acute myocardial infarction （MI） according to whether or not they developed ventricular fibrillation （VF） during the acute stage of MI.

    METHODS AND RESULTS: Among 3670 MI patients hospitalized in France in 2005 and enrolled in this prospective follow-up cohort study, we assessed in-hospital mortality and 5-year cause of death among those who survived to hospital discharge, according to whether they developed VF （116 cases） or not, during the acute stage. 94.5% of patients had complete follow-up at 5 years. In-hospital mortality was significantly higher among VF patients （adjusted OR 7.38, 95% CI 4.27-12.75, P < 0.001）。 Among 3463 survivors at hospital discharge, 1024 died during a mean follow-up of 52 ± 2 months. The overall survival rate at 5 years was 74.4% （95% CI 72.8-76.0）。 In Cox multivariate **ysis, occurrence of VF during the acute phase of MI was not associated with an increased mortality at 5 years （HR 0.78, 95% CI 0.38-1.58, P = 0.21）。 The distribution of causes of death at 5 years did not statistically differ according to the presence or absence of VF, especially for sudden cardiac death （13.1% in VF group vs.12.9% in non-VF group）， despite a very low rate of implantation of cardioverter defibrillator in both groups （Overall rate 1.2%）。

    CONCLUSION: Patients developing VF in the setting of acute MI are at higher risk of in-hospital mortality. However, VF is not associated with a higher long-term all-cause or sudden cardiac death mortality.