Ventricular Fibrillation Recurrences in Successfully Shocked Out-of-Hospital Cardiac Arrests
<i>Background and Objectives:</i> The prognostic impact of ventricular fibrillation (VF) recurrences after a successful shock in out-of-hospital cardiac arrest (OOHCA) is still poorly understood, and some evidence suggests a potential pro-arrhythmic effect of chest compressions in this s...
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MDPI AG
2021-04-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/57/4/358 |
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| author | Daniela Aschieri Federico Guerra Valentina Pelizzoni Enrico Paolini Giulia Stronati Luca Moderato Giulia Losi Paolo Compagnucci Michela Coccia Michela Casella Antonio Dello Russo Gust H. Bardy Alessandro Capucci |
| author_facet | Daniela Aschieri Federico Guerra Valentina Pelizzoni Enrico Paolini Giulia Stronati Luca Moderato Giulia Losi Paolo Compagnucci Michela Coccia Michela Casella Antonio Dello Russo Gust H. Bardy Alessandro Capucci |
| author_sort | Daniela Aschieri |
| collection | DOAJ |
| description | <i>Background and Objectives:</i> The prognostic impact of ventricular fibrillation (VF) recurrences after a successful shock in out-of-hospital cardiac arrest (OOHCA) is still poorly understood, and some evidence suggests a potential pro-arrhythmic effect of chest compressions in this setting. In the present analysis, we looked at the short-term and long-term prognosis of VF recurrences in OOHCA. And their potential association with chest compressions. <i>Materials and Methods:</i> The Progetto Vita, prospectively collecting data on all resuscitation efforts in the Piacenza province (Italy), was used for the present analysis. From the 461 OOHCAs found in a shockable rhythm, only those with optimal ECG tracings and good audio recordings (160) were assessed. Rhythms other than VF post-shock were analyzed five seconds after shock delivery and survival to hospital admission, hospital discharge, and long-term survival data over a 14-year follow-up were collected. <i>Results:</i> Population mean age was 64.4 ± 16.9 years, and 31.9% of all patients were female. Mean time to EMS arrival was 5.9 ± 4.5 min. Short- and long-term survival without neurological impairment were higher in patients without VF recurrence when compared to patients with VF recurrence, independently from the pre-induction rhythm (<i>p</i> < 0.001). After shock delivery, VF recurrence was higher when chest compressions were resumed early after discharge and more vigorously. <i>Conclusions:</i> VF recurrences after a shock could worsen short and long-term survival. The potential pro-arrhythmic effect of chest compressions should be factored in when considering the real risks and benefits of this procedure. |
| first_indexed | 2024-03-10T12:31:51Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T12:31:51Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-5ad387ae8e764544913a75e5827ccd7b2023-11-21T14:34:13ZengMDPI AGMedicina1010-660X1648-91442021-04-0157435810.3390/medicina57040358Ventricular Fibrillation Recurrences in Successfully Shocked Out-of-Hospital Cardiac ArrestsDaniela Aschieri0Federico Guerra1Valentina Pelizzoni2Enrico Paolini3Giulia Stronati4Luca Moderato5Giulia Losi6Paolo Compagnucci7Michela Coccia8Michela Casella9Antonio Dello Russo10Gust H. Bardy11Alessandro Capucci12Cardiology Department, Civil Hospital, 29015 Castel San Giovanni, ItalyDepartment of Biomedical Science and Public Health, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60020 Ancona, ItalyCardiology Department, “Guglielmo da Saliceto” Hospital, 29121 Piacenza, ItalyCardiology Department, “Ospedali Riuniti Marche Nord”, 61121 Pesaro, ItalyDepartment of Biomedical Science and Public Health, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60020 Ancona, ItalyCardiology Department, “Guglielmo da Saliceto” Hospital, 29121 Piacenza, ItalyCardiology Department, Civil Hospital, 29015 Castel San Giovanni, ItalyDepartment of Biomedical Science and Public Health, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60020 Ancona, ItalyCardiology Department, Civil Hospital, 29015 Castel San Giovanni, ItalyDepartment of Clinical, Special and Dental Sciences, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60020 Ancona, ItalyDepartment of Biomedical Science and Public Health, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60020 Ancona, ItalySeattle Institute for Cardiac Research, Seattle, WA 98195, USADepartment of Biomedical Science and Public Health, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60020 Ancona, Italy<i>Background and Objectives:</i> The prognostic impact of ventricular fibrillation (VF) recurrences after a successful shock in out-of-hospital cardiac arrest (OOHCA) is still poorly understood, and some evidence suggests a potential pro-arrhythmic effect of chest compressions in this setting. In the present analysis, we looked at the short-term and long-term prognosis of VF recurrences in OOHCA. And their potential association with chest compressions. <i>Materials and Methods:</i> The Progetto Vita, prospectively collecting data on all resuscitation efforts in the Piacenza province (Italy), was used for the present analysis. From the 461 OOHCAs found in a shockable rhythm, only those with optimal ECG tracings and good audio recordings (160) were assessed. Rhythms other than VF post-shock were analyzed five seconds after shock delivery and survival to hospital admission, hospital discharge, and long-term survival data over a 14-year follow-up were collected. <i>Results:</i> Population mean age was 64.4 ± 16.9 years, and 31.9% of all patients were female. Mean time to EMS arrival was 5.9 ± 4.5 min. Short- and long-term survival without neurological impairment were higher in patients without VF recurrence when compared to patients with VF recurrence, independently from the pre-induction rhythm (<i>p</i> < 0.001). After shock delivery, VF recurrence was higher when chest compressions were resumed early after discharge and more vigorously. <i>Conclusions:</i> VF recurrences after a shock could worsen short and long-term survival. The potential pro-arrhythmic effect of chest compressions should be factored in when considering the real risks and benefits of this procedure.https://www.mdpi.com/1648-9144/57/4/358cardiac arrestcardiopulmonary resuscitationchest compressionssudden cardiac deathventricular fibrillationdefibrillation |
| spellingShingle | Daniela Aschieri Federico Guerra Valentina Pelizzoni Enrico Paolini Giulia Stronati Luca Moderato Giulia Losi Paolo Compagnucci Michela Coccia Michela Casella Antonio Dello Russo Gust H. Bardy Alessandro Capucci Ventricular Fibrillation Recurrences in Successfully Shocked Out-of-Hospital Cardiac Arrests Medicina cardiac arrest cardiopulmonary resuscitation chest compressions sudden cardiac death ventricular fibrillation defibrillation |
| title | Ventricular Fibrillation Recurrences in Successfully Shocked Out-of-Hospital Cardiac Arrests |
| title_full | Ventricular Fibrillation Recurrences in Successfully Shocked Out-of-Hospital Cardiac Arrests |
| title_fullStr | Ventricular Fibrillation Recurrences in Successfully Shocked Out-of-Hospital Cardiac Arrests |
| title_full_unstemmed | Ventricular Fibrillation Recurrences in Successfully Shocked Out-of-Hospital Cardiac Arrests |
| title_short | Ventricular Fibrillation Recurrences in Successfully Shocked Out-of-Hospital Cardiac Arrests |
| title_sort | ventricular fibrillation recurrences in successfully shocked out of hospital cardiac arrests |
| topic | cardiac arrest cardiopulmonary resuscitation chest compressions sudden cardiac death ventricular fibrillation defibrillation |
| url | https://www.mdpi.com/1648-9144/57/4/358 |
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