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Postresuscitation accelerated idioventricular rhythm: a potential prognostic factor for out-of-hospital cardiac arrest survivors.

AbstractOBJECTIVE:
Data are lacking on the relationship between postresuscitation ECG and outcome in out-of-hospital cardiac arrest (OHCA). We examined the prognostic information that postresuscitation ECG rhythm can provide for predicting outcome in OHCA survivors.
METHODS:
The retrospective observational study enrolled 56 successfully resuscitated nontraumatic adult OHCA patients. Postresuscitation 12-lead ECGs of the enrolled patients were interpreted independently by two cardiologists. We compared baseline clinical characteristics, CPR process, and outcome in the 8 patients with postresuscitation accelerated idioventricular rhythm (AIVR, n = 8) and the 48 without AIVR.
RESULTS:
The AIVR group had a higher proportion of patients with coronary artery disease (50% vs. 15%), initial ventricular tachycardia/fibrillation rhythm (50% vs. 8%), and cardiac origin of OHCA (75% vs. 23%). AIVR patients had longer total CPR duration (32 vs. 18 min) and higher dose of epinephrine use (10 vs. 3 mg). Postresuscitation AIVR was associated with an increased incidence of repeated CPR within 1 h after return of spontaneous circulation (38% vs. 4%), and lower 7-day survival rate (0% vs. 50%).
CONCLUSIONS:
AIVR on postresuscitation ECG offers a prognostic factor related to a higher repeated CPR rate within 1h after return of spontaneous circulation and a lower 7-day survival rates in successfully resuscitated OHCA victims.
AuthorsMin-Shan Tsai, Chien-Hua Huang, Hung-Ren Chen, Cheng-Chun Hsieh, Wei-Tien Chang, Chiung-Yuan Hsu, Matthew Huei-Ming Ma, Shyr-Chyr Chen, Wen-Jone Chen
JournalIntensive care medicine (Intensive Care Med) Vol. 33 Issue 9 Pg. 1628-32 (Sep 2007) ISSN: 0342-4642 [Print] United States
PMID17457573 (Publication Type: Journal Article)
Chemical References
  • Vasoconstrictor Agents
  • Epinephrine
Topics
  • Accelerated Idioventricular Rhythm (epidemiology)
  • Aged
  • Aged, 80 and over
  • Cardiopulmonary Resuscitation
  • Coronary Artery Disease (epidemiology)
  • Electrocardiography
  • Epinephrine (administration & dosage)
  • Female
  • Heart Arrest (mortality, therapy)
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Retreatment
  • Retrospective Studies
  • Survival Analysis
  • Survivors
  • Tachycardia, Ventricular (epidemiology)
  • Time Factors
  • Vasoconstrictor Agents (administration & dosage)

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