Out-of-hospital cardiac arrest in patients with cardiac amyloidosis: presenting rhythms, management and outcomes in four patients.
Primary systemic amyloidosis (AL) is a well-recognized systemic disease, and cardiac amyloidosis accounts for 10% of all nonischemic cardiomyopathies [J S C Med Assoc 97 (2001) 201-206]. The median survival of patients with symptomatic congestive heart failure secondary to cardiac amyloidosis is 4 months [New Engl J Med 336 (1997) 1202-1207; Am J Med 100 (1996) 290-298]. The cause of death in most patients is refractory congestive heart failure or sudden arrhythmic [Mayo Clin Proc 59 (1984) 589-597]. While there are reports of in-hospital arrhythmic deaths in these patients, there are no detailed reports that describe the presentation and management of patients with cardiac amyloidosis who have experienced an out-of-hospital cardiac arrest (OHCA). We describe here our experience with four patients with AL who had an OHCA, including presenting rhythms, interventions, and outcomes.
Emergency Medicine, Mayo Clinic, Rochester, MN, USA.
Erik P
EP
Hess
Roger D
RD
White
D000686:Amyloidosis / Q000150:complications* / Q000503:physiopathology; D009202:Cardiomyopathies / Q000150:complications* / Q000503:physiopathology; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D017809:Fatal Outcome; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000503:physiopathology / Q000628:therapy*; D006333:Heart Failure / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000503:physiopathology / Q000628:therapy