Chest compressions cause recurrence of ventricular fibrillation after the first successful conversion by defibrillation in out-of-hospital cardiac arrest.

نویسندگان

  • Jocelyn Berdowski
  • Jan G P Tijssen
  • Rudolph W Koster
چکیده

BACKGROUND Unlike Resuscitation Guidelines (GL) 2000, GL2005 advise resuming cardiopulmonary resuscitation (CPR) immediately after defibrillation. We hypothesized that immediate CPR resumption promotes earlier recurrence of ventricular fibrillation (VF). METHODS AND RESULTS This study used data of a prospective per-patient randomized controlled trial. Automated external defibrillators used by first responders were randomized to either (1) perform postshock analysis and prompt rescuers to a pulse check (GL2000), or (2) resume CPR immediately after defibrillation (GL2005). Continuous recordings of ECG and impedance signals were collected from all patients with an out-of-hospital cardiac arrest to whom a randomized automated external defibrillator was applied. We included patients with VF as their initial rhythm in whom CPR onset could be determined from the ECG and impedance signals. Time intervals are presented as median (Q1-to-Q3). Of 361 patients, 136 met the inclusion criteria: 68 were randomly assigned to GL2000 and 68 to GL2005. Rescuers resumed CPR 30 (21-to-39) and 8 (7-to-9) seconds, respectively, after the first shock that successfully terminated VF (P<0.001); VF recurred after 40 (21-to-76) and 21 (10-to-80) seconds, respectively (P=0.001). The time interval between start of CPR and VF recurrence was 6 (0-to-67) and 8 (3-to-61) seconds, respectively (P=0.88). The hazard ratio for VF recurrence in the first 2 seconds of CPR was 15.5 (95% confidence interval, 5.63 to 57.7) compared with before CPR resumption. After more than 8 seconds of CPR, the hazard of VF recurrence was similar to before CPR resumption. CONCLUSIONS Early CPR resumption after defibrillation causes early VF recurrence. Clinical Trial Registration- clinicaltrials.gov Identifier: ISRCTN72257677.

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منابع مشابه

“Resumption of Chest Compressions After Successful Defibrillation and Risk for Recurrence of Ventricular Fibrillation in Out-of-Hospital Cardiac Arrest”

Letter by Shiyovich et al Regarding Article, “Resumption of Chest Compressions After Successful Defibrillation and Risk for Recurrence of Ventricular Fibrillation in Out-of-Hospital Cardiac Arrest” In their study, Conover et al investigated whether ventricular fibrillation (VF) recurrence in first 30 s post shock of cardiac arrest victims with initial rhythm of VF is related to timing of post s...

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“Resumption of Chest Compressions After Successful Defibrillation and Risk for Recurrence of Ventricular Fibrillation in Out-of-Hospital Cardiac Arrest”

Letter by Shiyovich et al Regarding Article, “Resumption of Chest Compressions After Successful Defibrillation and Risk for Recurrence of Ventricular Fibrillation in Out-of-Hospital Cardiac Arrest” In their study, Conover et al investigated whether ventricular fibrillation (VF) recurrence in first 30 s post shock of cardiac arrest victims with initial rhythm of VF is related to timing of post s...

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Delaying shock for cardiopulmonary resuscitation: does it save lives?

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عنوان ژورنال:
  • Circulation. Arrhythmia and electrophysiology

دوره 3 1  شماره 

صفحات  -

تاریخ انتشار 2010