Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2022 Nov 5;22(1):466.
doi: 10.1186/s12872-022-02920-2.

Comparison of the effects of lidocaine and amiodarone for out-of-hospital cardiac arrest patients with shockable rhythms: a retrospective observational study from a multicenter registry

Yuki Kishihara  1 , Masahiro Kashiura  2 , Shunsuke Amagasa  3 , Fumihito Fukushima  1 , Hideto Yasuda  1   4 , Takashi Moriya  1
Affiliations
Observational Study

Comparison of the effects of lidocaine and amiodarone for out-of-hospital cardiac arrest patients with shockable rhythms: a retrospective observational study from a multicenter registry

Yuki Kishihara et al. BMC Cardiovasc Disord. .

Abstract

Background: Out-of-hospital cardiac arrest (OHCA) with shockable rhythms, including ventricular fibrillation and pulseless ventricular tachycardia, is associated with better prognosis and neurological outcome than OHCA due to other rhythms. Antiarrhythmic drugs, including lidocaine and amiodarone, are often used for defibrillation. This study aimed to compare the effects of lidocaine and amiodarone on the prognosis and neurological outcome of patients with OHCA due to shockable rhythms in a real-world setting.

Methods: We conducted a retrospective observational study using a multicenter OHCA registry of 91 participating hospitals in Japan. We included adult patients with shockable rhythms, such as ventricular fibrillation and pulseless ventricular tachycardia, who were administered either lidocaine or amiodarone. The primary outcome was 30-day survival, and the secondary outcome was a good neurological outcome at 30 days. We compared the effects of lidocaine and amiodarone for patients with OHCA due to shockable rhythms for these outcomes using logistic regression analysis after propensity score matching (PSM).

Results: Of the 51,199 patients registered in the OHCA registry, 1970 patients were analyzed. In total, 105 patients (5.3%) were administered lidocaine, and 1865 (94.7%) were administered amiodarone. After performing PSM with amiodarone used as the reference, the odds ratios and 95% confidence intervals of lidocaine use for 30-day survival and 30-day good neurological outcome were 1.44 (0.58-3.61) and 1.77 (0.59-5.29), respectively.

Conclusion: The use of lidocaine and amiodarone for patients with OHCA due to shockable rhythms within a real-world setting showed no significant differences in short-term mortality or neurological outcome. There is no evidence that either amiodarone or lidocaine is superior in treatment; thus, either or both drugs could be administered.

Keywords: Amiodarone; Lidocaine; Out-of-hospital cardiac arrest; Shockable rhythm.

PubMed Disclaimer

Conflict of interest statement

All the authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart depicting the screening and enrolment process within this study. OHCA, out-of-hospital cardiac arrest
See this image and copyright information in PMC

References

    1. Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, et al. Heart disease and stroke Statistics-2018 update: a report from the American Heart Association. Circulation. 2018;137:e67–e492. doi: 10.1161/CIR.0000000000000558. - DOI - PubMed
    1. Gräsner JT, Lefering R, Koster RW, Masterson S, Böttiger BW, Herlitz J, et al. EuReCa ONE-27 nations, ONE Europe, ONE registry: a prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe. Resuscitation. 2016;105:188–195. doi: 10.1016/j.resuscitation.2016.06.004. - DOI - PubMed
    1. SOS-KANTO study group Cardiopulmonary resuscitation by bystanders with chest compression only (SOS-KANTO): an observational study. Lancet. 2007;369:920–926. doi: 10.1016/S0140-6736(07)60451-6. - DOI - PubMed
    1. Lim ZJ, Ponnapa Reddy MP, Afroz A, Billah B, Shekar K, Subramaniam A. Incidence and outcome of out-of-hospital cardiac arrests in the COVID-19 era: a systematic review and meta-analysis. Resuscitation. 2020;157:248–258. doi: 10.1016/j.resuscitation.2020.10.025. - DOI - PMC - PubMed
    1. Rajan S, Folke F, Hansen SM, Hansen CM, Kragholm K, Gerds TA, et al. Incidence and survival outcome according to heart rhythm during resuscitation attempt in out-of-hospital cardiac arrest patients with presumed cardiac etiology. Resuscitation. 2017;114:157–163. doi: 10.1016/j.resuscitation.2016.12.021. - DOI - PubMed

Publication types

MeSH terms