AIMS: The reported proportion of ventricular fibrillation (VF) in out-of-hospital cardiac arrest (OHCA) has declined worldwide. VF decline may be caused by less VF at collapse and/or faster dissolution of VF into asystole. We aimed to determine the causes of VF decline by comparing VF proportions in relation to delay from emergency medical services (EMS) call to initial ECG (call-to-ECG delay), and VF dissolution rates between two study periods. METHODS: Data from the AmsteRdam REsuscitation STudies (ARREST), an ongoing OHCA registry in the Netherlands, were used. We studied cardiac OHCA in the study periods 1995-1997 (n=917) and 2006-2012 (n=5695). Cases with available ECG and information on call-to-ECG delay were included. We tested whether initial VF proportion and VF dissolution rates differed between both study periods using logistic regression. RESULTS: Despite a 15% VF decline between the periods, VF proportion around EMS call remained high in 2006-2012 (64%). The odds ratio (OR) for VF proportion in 2006-2012 vs. 1995-1997 was 0.52 (95%-CI 0.45-0.60, P<0.001), with similar rates of VF dissolution in both periods (P=0.83). VF decline was higher for unwitnessed collapse (OR 0.41, 95%-CI 0.28-0.58) and collapse at home (OR 0.50, 95%-CI 0.42-0.59), but not for categories of bystander CPR, age or sex. CONCLUSION: VF proportion early after collapse remains high. VF decline is explained by the occurrence of less initial VF, rather than faster dissolving VF. An increase in unwitnessed OHCA and collapse at home contributes to the observed VF decline.
AIMS: The reported proportion of ventricular fibrillation (VF) in out-of-hospital cardiac arrest (OHCA) has declined worldwide. VF decline may be caused by less VF at collapse and/or faster dissolution of VF into asystole. We aimed to determine the causes of VF decline by comparing VF proportions in relation to delay from emergency medical services (EMS) call to initial ECG (call-to-ECG delay), and VF dissolution rates between two study periods. METHODS: Data from the AmsteRdam REsuscitation STudies (ARREST), an ongoing OHCA registry in the Netherlands, were used. We studied cardiac OHCA in the study periods 1995-1997 (n=917) and 2006-2012 (n=5695). Cases with available ECG and information on call-to-ECG delay were included. We tested whether initial VF proportion and VF dissolution rates differed between both study periods using logistic regression. RESULTS: Despite a 15% VF decline between the periods, VF proportion around EMS call remained high in 2006-2012 (64%). The odds ratio (OR) for VF proportion in 2006-2012 vs. 1995-1997 was 0.52 (95%-CI 0.45-0.60, P<0.001), with similar rates of VF dissolution in both periods (P=0.83). VF decline was higher for unwitnessed collapse (OR 0.41, 95%-CI 0.28-0.58) and collapse at home (OR 0.50, 95%-CI 0.42-0.59), but not for categories of bystander CPR, age or sex. CONCLUSION:VF proportion early after collapse remains high. VF decline is explained by the occurrence of less initial VF, rather than faster dissolving VF. An increase in unwitnessed OHCA and collapse at home contributes to the observed VF decline.
Authors: Christopher B Fordyce; Carolina M Hansen; Kristian Kragholm; Matthew E Dupre; James G Jollis; Mayme L Roettig; Lance B Becker; Steen M Hansen; Tomoya T Hinohara; Claire C Corbett; Lisa Monk; R Darrell Nelson; David A Pearson; Clark Tyson; Sean van Diepen; Monique L Anderson; Bryan McNally; Christopher B Granger Journal: JAMA Cardiol Date: 2017-11-01 Impact factor: 14.676
Authors: Carlo A Barcella; Talip E Eroglu; Michiel Hulleman; Asger Granfeldt; Patrick C Souverein; Grimur H Mohr; Rudolph W Koster; Mads Wissenberg; Anthonius de Boer; Christian Torp-Pedersen; Fredrik Folke; Marieke T Blom; Gunnar H Gislason; Hanno L Tan Journal: Europace Date: 2020-08-01 Impact factor: 5.214
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Authors: Carolina Malta Hansen; Kristian Kragholm; Matthew E Dupre; David A Pearson; Clark Tyson; Lisa Monk; Thomas D Rea; Monique A Starks; Darrell Nelson; James G Jollis; Bryan McNally; Claire M Corbett; Christopher B Granger Journal: J Am Heart Assoc Date: 2018-09-18 Impact factor: 5.501
Authors: Klaudiusz Nadolny; Lukasz Szarpak; Joanna Gotlib; Mariusz Panczyk; Maciej Sterlinski; Jerzy Robert Ladny; Jacek Smereka; Robert Galazkowski Journal: Medicine (Baltimore) Date: 2018-07 Impact factor: 1.889