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Ventricular fibrillation recurrences in successfully shocked out-of-hospital cardiac arrests

Title: Ventricular fibrillation recurrences in successfully shocked out-of-hospital cardiac arrests
Authors: Aschieri D.; Guerra F.; Pelizzoni V.; Paolini E.; Stronati G.; Moderato L.; Losi G.; Compagnucci P.; Coccia M.; Casella M.; Dello Russo A.; Bardy G. H.; Capucci A.
Contributors: Aschieri, D.; Guerra, F.; Pelizzoni, V.; Paolini, E.; Stronati, G.; Moderato, L.; Losi, G.; Compagnucci, P.; Coccia, M.; Casella, M.; Dello Russo, A.; Bardy, G. H.; Capucci, A.
Publication Year: 2021
Collection: Università Politecnica delle Marche: IRIS
Subject Terms: Cardiac arrest; Cardiopulmonary resuscitation; Chest compression; Defibrillation; Sudden cardiac death; Ventricular fibrillation; Aged; 80 and over; Female; Human; Italy; Male; Middle Aged; Recurrence; Emergency Medical Service; Out-of-Hospital Cardiac Arrest
Description: Background and Objectives: The prognostic impact of ventricular fibrillation (VF) recurrences after a successful shock in out-of-hospital cardiac arrest (OOHCA) is still poorly understood, and some evidence suggests a potential pro-arrhythmic effect of chest compressions in this setting. In the present analysis, we looked at the short-term and long-term prognosis of VF recurrences in OOHCA. And their potential association with chest compressions. Materials and Methods: The Progetto Vita, prospectively collecting data on all resuscitation efforts in the Piacenza province (Italy), was used for the present analysis. From the 461 OOHCAs found in a shockable rhythm, only those with optimal ECG tracings and good audio recordings (160) were assessed. Rhythms other than VF postshock were analyzed five seconds after shock delivery and survival to hospital admission, hospital discharge, and long-term survival data over a 14-year follow-up were collected. Results: Population mean age was 64.4 ± 16.9 years, and 31.9% of all patients were female. Mean time to EMS arrival was 5.9 ± 4.5 min. Short-and long-term survival without neurological impairment were higher in patients without VF recurrence when compared to patients with VF recurrence, independently from the pre-induction rhythm (p < 0.001). After shock delivery, VF recurrence was higher when chest compressions were resumed early after discharge and more vigorously. Conclusions: VF recurrences after a shock could worsen short and long-term survival. The potential pro-arrhythmic effect of chest compressions should be factored in when considering the real risks and benefits of this procedure.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/33917184; info:eu-repo/semantics/altIdentifier/wos/WOS:000643209400001; volume:57; issue:4; firstpage:358; journal:MEDICINA; https://hdl.handle.net/11566/293087
DOI: 10.3390/medicina57040358
Availability: https://hdl.handle.net/11566/293087; https://doi.org/10.3390/medicina57040358
Rights: info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.8737BEA
Database: BASE