Out-of-hospital cardiac arrest outcomes stratified by rhythm analysis

Pulseless Electric Activity

“…12,13 In the Seattle study, 6 61% of cardiac arrests responded to by emergency medical services had VF identified as the initial rhythm in 1979 to 1980 compared with 41% in 1999 to 2000. In contrast, PEA was identified as the first rhythm recorded in 17% of the victims in the earlier period compared with 28% in the later period.…”

“…In parallel with this reduced frequency of VT/VF, recent unpublished data from the Resuscitation Outcomes Consortium and data from the Cardiac Arrest Registry to Enhance Survival network demonstrate an incidence of PEA arrests ranging from 19% to 23%, with the remaining ≈50% of patients initially having asystole. 13 This striking decline in the frequency of VT/VF and the relative and possibly absolute increase in PEA and asystole as the initial rhythm may be attributable to a number of interacting environmental, clinical, pharmacological, or strategic interventional factors. At least one of these may be analyzed in the context of the location of cardiac arrests.…”

“…Similar low survival rates were reported by the Cardiac Arrest Registry to Enhance Survival Network. 13 However, data from 1 report suggest that survival from PEA arrests appears to be improving over time. Among 627 PEA arrests treated in Seattle from 2000 to 2004, survival to 1 month was 9.9% and survival to 1 year was 6.2%.…”

Coming to life: The study of out-of-hospital cardiac arrest

“…OHCA victims who present with PEA/asystole are less likely to survive than those who present with VT/VF. 11,12 Therefore, a better grasp of the rising incidence of PEA/asystole may lead to better strategies for improving survival. Unfortunately, the electrophysiological states in cardiac arrest are complex and dynamic, with frequent transitions between shockable and non-shockable rhythms.…”

Systematic downloading and analysis of data from automated external defibrillators used in out-of-hospital cardiac arrest

“…2,[8][9][10] These studies were performed at selected locations or with persons trained to use an AED and therefore does not reflect the general effect of public-access defibrillation (PAD). The proportion of shockable rhythm has declined and is now reported to be approximately 25%, [11][12][13][14] thus questioning the lifesaving potentials of the PAD. Recently, a large nationwide Danish study showed that 27.6% (95% CI [27.0-28.3]) of the victims with OHCA of presumed cardiac origin had a shockable rhythm.…”