Anouk P van Alem1, Jelle Post, Rudolph W Koster. 1. Department of Cardiology, Academic Medical Centre, room B2-239, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands. a.p.vanalem@amc.uva.nl
Abstract
BACKGROUND: Refibrillation after successful defibrillation in out-of-hospital cardiac arrest is a frequent event. Little is known of factors that predispose to the occurrence of refibrillation. The effect of recurrence of ventricular fibrillation (VF) on survival is not known. METHODS: Data of patients in out-of-hospital cardiac arrest were collected in a combined first responder and paramedic programme in Amsterdam, the Netherlands. Continuous recorded rhythm data of 322 patients covering the entire out-of-hospital resuscitation attempt was included in the analysis. Recurrence of VF was recorded, the patient and process characteristics were analysed in relation to the occurrence of refibrillation. The number of refibrillations was related to survival. RESULTS AND CONCLUSION: Of the studied patients 79% had at least one recurrence of VF, and a median number of two times 25-75%; one to four times). The median time from successful first shock to VF recurrence was 45 s (25-75%: 23-115 s). A significant inverse relation was found between the number of refibrillations and survival of out-of-hospital cardiac arrest. The recurrence of VF was independent of the underlying cardiac disorder, the time to defibrillation, the defibrillation waveform and other characteristics of the patient and the process. Anti-arrhythmics should be considered in all patients found in VF to reduce the number of recurrences.
BACKGROUND: Refibrillation after successful defibrillation in out-of-hospital cardiac arrest is a frequent event. Little is known of factors that predispose to the occurrence of refibrillation. The effect of recurrence of ventricular fibrillation (VF) on survival is not known. METHODS: Data of patients in out-of-hospital cardiac arrest were collected in a combined first responder and paramedic programme in Amsterdam, the Netherlands. Continuous recorded rhythm data of 322 patients covering the entire out-of-hospital resuscitation attempt was included in the analysis. Recurrence of VF was recorded, the patient and process characteristics were analysed in relation to the occurrence of refibrillation. The number of refibrillations was related to survival. RESULTS AND CONCLUSION: Of the studied patients 79% had at least one recurrence of VF, and a median number of two times 25-75%; one to four times). The median time from successful first shock to VF recurrence was 45 s (25-75%: 23-115 s). A significant inverse relation was found between the number of refibrillations and survival of out-of-hospital cardiac arrest. The recurrence of VF was independent of the underlying cardiac disorder, the time to defibrillation, the defibrillation waveform and other characteristics of the patient and the process. Anti-arrhythmics should be considered in all patients found in VF to reduce the number of recurrences.
Authors: Peter J Kudenchuk; Siobhan P Brown; Mohamud Daya; Laurie J Morrison; Brian E Grunau; Tom Rea; Tom Aufderheide; Judy Powell; Brian Leroux; Christian Vaillancourt; Jonathan Larsen; Lynn Wittwer; M Riccardo Colella; Shannon W Stephens; Mark Gamber; Debra Egan; Paul Dorian Journal: Am Heart J Date: 2014-03-01 Impact factor: 4.749
Authors: David D Salcido; Robert H Schmicker; Noah Kime; Jason E Buick; Sheldon Cheskes; Brian Grunau; Stephanie Zellner; Dana Zive; Tom P Aufderheide; Allison C Koller; Heather Herren; Jack Nuttall; Matthew L Sundermann; James J Menegazzi Journal: Resuscitation Date: 2018-05-24 Impact factor: 5.262