VF recurrence: characteristics and patient outcome in out-of-hospital cardiac arrest.
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.


CONCLUSIONS
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.
van Alem
Anouk P
AP
Department of Cardiology, Academic Medical Centre, room B2-239, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands. a.p.vanalem@amc.uva.nl
Post
Jelle
J
Koster
Rudolph W
RW
D017677:Age Distribution; D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D004554:Electric Countershock / Q000379:methods*; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011336:Probability; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D014505:Urban Population; D014693:Ventricular Fibrillation / Q000401:mortality / Q000628:therapy*