Postresuscitation accelerated idioventricular rhythm: a potential prognostic factor for out-of-hospital cardiac arrest survivors

Abstract

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.