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Refractory ventricular arrhythmia is certainly a serious problem in acute myocardial

Refractory ventricular arrhythmia is certainly a serious problem in acute myocardial infarction (AMI), with an extremely high mortality rate and limited effective treatment. arrhythmia in acute myocardial infarction. The presence of profound anoxic encephalopathy and acute renal failure requiring dialysis were significant prognostic factors. INTRODUCTION Mortality and complications associated with acute myocardial infarction (AMI) have gradually decreased in the era of reperfusion therapy.1 However, the outcomes are still poor in patients with ventricular arrhythmia in AMI who need resuscitation.2,3 Refractory ventricular arrhythmia is even more challenging with an extremely high mortality rate.4 Current guidelines focus on medical and defibrillation therapy when facing ventricular arrhythmia in patients with AMI.5,6 However, the available treatment modalities for patients with refractory ventricular arrhythmia are still limited. Intraaortic balloon pump support is usually a possible answer in such circumstances, even though results have been reported to be unacceptable due to extremely high mortality rate.4,7 Extracorporeal membrane oxygenation (ECMO) provides cardiopulmonary support and is used to rescue patients with cardiopulmonary collapse.8,9 In patients with AMI, ECMO is suggested for temporary support in those with acute heart failure with the potential for functional recovery following revascularization.7 In recent studies, ECMO has been reported to improve outcomes in patients with AMI with cardiogenic shock, and that early ECMO initiation yields better outcomes.10 Moreover, a previous study demonstrated a significant increase in survival using ECMO in patients with cardiogenic shock compared with intraaortic balloon pump support.4 The previous studies suggest that ECMO is a potential answer for patients with refractory ventricular arrhythmia in AMI. However, little is known about the efficacy of such treatment in these patients, and it has not been pointed out in current guidelines.5,6 Therefore, we assessed the efficacy of ECMO as rescue therapy and as a bridge to revascularization in patients with refractory ventricular arrhythmia in AMI. METHODS Establishing and Populace The present study was conducted at National Taiwan University or college Hospital, a university-affiliated 2200-bed hospital in northern Taiwan. This hospital is also an ECMO referral center and tertiary medical center. We founded a computerized case record form prospectively and collected the demographic data, medical features, and WASL results of individuals undergoing ECMO.8 Adult individuals who required ECMO for AMI-induced refractory ventricular arrhythmia between February 2001 and January 2013 were included. The inclusion criteria were an age of 18 years or older, and those who received venoarterial ECMO for circulatory SB-505124 hydrochloride supplier collapse despite standard cardiopulmonary resuscitation and medical treatment, and a medical analysis of AMI-induced refractory ventricular arrhythmia before ECMO. The exclusion criteria were those who did not receive coronary catheterization during this hospitalization, and who receive ECMO implantation during or after revascularization therapy. Main endpoint was mortality on index admission. Secondary endpoint was mortality on index admission or advanced mind damage at discharge. The institutional review table of National Taiwan University hospital approved the study and waived for the need of knowledgeable consent (Ref: 201409041RIN). Meanings The analysis of AMI was made by electrocardiography, medical history, and the presence of cardiac necrosis markers in serum. The definition of ST-elevation myocardial infarction (STEMI) was fresh ST elevation in the SB-505124 hydrochloride supplier J point in at least 2 contiguous prospects of 2?mm (0.2?mV) in males or 1.5?mm (0.15?mV) in women in prospects SB-505124 hydrochloride supplier V2CV3, and/or of 1 1?mm (0.1?mV) in other contiguous chest prospects or the limb prospects. New or presumably fresh left package branch block was considered to be equivalent to STEMI.6 Refractory ventricular arrhythmia was defined as persistent ventricular arrhythmia even with the use of antiarrhythmia medications, cardioversion, and cardiopulmonary resuscitation.4 Venoarterial ECMO was delivered to the appropriate candidates when refractory ventricular arrhythmia occurred. ECMO-assisted cardiopulmonary resuscitation (E-CPR) was defined as.