Postresuscitation accelerated idioventricular rhythm: a potential prognostic factor for out-of-hospital cardiac arrest survivors.
OBJECTIVE
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.
Tsai
Min-Shan
MS
National Taiwan University Hospital and College of Medicine, Department of Emergency Medicine, No. 7 Chung-Shan S. Road, 100 Taipei, Taiwan.
Huang
Chien-Hua
CH
Chen
Hung-Ren
HR
Hsieh
Cheng-Chun
CC
Chang
Wei-Tien
WT
Hsu
Chiung-Yuan
CY
Ma
Matthew Huei-Ming
MH
Chen
Shyr-Chyr
SC
Chen
Wen-Jone
WJ
D016170:Accelerated Idioventricular Rhythm / Q000453:epidemiology*; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D003324:Coronary Artery Disease / Q000453:epidemiology; D004562:Electrocardiography; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D019233:Retreatment; D012189:Retrospective Studies; D016019:Survival Analysis; D017741:Survivors; D017180:Tachycardia, Ventricular / Q000453:epidemiology; D013997:Time Factors; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
D014662:Vasoconstrictor Agents; D004837:Epinephrine