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.
Hess
Erik P
EP
Emergency Medicine, Mayo Clinic, Rochester, MN, USA.
White
Roger D
RD
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