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".

نویسندگان

  • Arthur Shiyovich
  • Alexander Gerovich
  • Amos Katz
چکیده

BACKGROUND Prior investigation of out-of-hospital cardiac arrest has raised the concern that ventricular fibrillation (VF) recurrence may be triggered by chest compression (CC) resumption. We investigated predictors of VF recurrence after defibrillation, including timing of CC resumption. METHODS AND RESULTS Patients with witnessed out-of-hospital cardiac arrest and initial rhythm of VF from an Utstein-style database were analyzed. For each shock that defibrillated VF, CC resumption and VF recurrence times were determined. Shocks were classified according to postshock rhythm. Factors (age, sex, time from dispatch to monitor/defibrillator application, and CC resumption) that could predict VF recurrence were analyzed. CC resumption was categorized into groups: CC1, 1 to 5 seconds; CC2, 6 to 10 seconds; CC3, 11 to 30 seconds; and CC4, >30 seconds. Eighty-eight subjects were analyzed, with a total of 285 shocks, with 226 shocks that achieved asystole (n=102), organized rhythm (n=120), or monomorphic ventricular tachycardia (n=4). After a successful shock, CC resumption occurred at a median (interquartile range) of 8 (5-18) seconds. VF recurred after 166 shocks (74%) and recurred within 30 seconds in 69 shocks. There was no significant relationship between VF recurrence and factors analyzed including CC resumption time, nor stratified by postshock rhythm. The hazard ratios (HRs) for VF recurrence within 30 seconds for later CC groups (CC2, CC3, and CC4) relative to early CC resumption (CC1) were as follows: HR(CC2)=1.05 (P=0.9); HR(CC3)=1.75 (P=0.1); and HR(CC4)=0.67 (P=0.4). CONCLUSIONS VF recurrence within 30 seconds of a defibrillatory shock was not dependent on timing of CC resumption in patients with witnessed arrest and initial rhythm of VF.

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Response to letter regarding, "resumption of chest compressions after successful defibrillation and risk for recurrence of ventricular fibrillation in out-of-hospital cardiac arrest".

Response to Letter Regarding, “Resumption of Chest Compressions After Successful Defibrillation and Risk for Recurrence of Ventricular Fibrillation in Out-of-Hospital Cardiac Arrest” We appreciate the thoughtful letter to the editor by Drs Shiyovich, Gerovich, and Katz. We examined whether an association exists between when chest compressions (CC) are resumed after a shock that defibrillates ve...

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

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...

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عنوان ژورنال:
  • Circulation. Arrhythmia and electrophysiology

دوره 7 4  شماره 

صفحات  -

تاریخ انتشار 2014