Ventricular Fibrillation Recurrences in Successfully Shocked Out-of-Hospital Cardiac Arrests
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
Affiliations
Daniela Aschieri
Cardiology Department, Civil Hospital, 29015 Castel San Giovanni, Italy
Federico Guerra
Department of Biomedical Science and Public Health, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60020 Ancona, Italy
Valentina Pelizzoni
Cardiology Department, “Guglielmo da Saliceto” Hospital, 29121 Piacenza, Italy
Department of Biomedical Science and Public Health, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60020 Ancona, Italy
Luca Moderato
Cardiology Department, “Guglielmo da Saliceto” Hospital, 29121 Piacenza, Italy
Giulia Losi
Cardiology Department, Civil Hospital, 29015 Castel San Giovanni, Italy
Paolo Compagnucci
Department of Biomedical Science and Public Health, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60020 Ancona, Italy
Michela Coccia
Cardiology Department, Civil Hospital, 29015 Castel San Giovanni, Italy
Michela Casella
Department of Clinical, Special and Dental Sciences, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60020 Ancona, Italy
Antonio Dello Russo
Department of Biomedical Science and Public Health, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60020 Ancona, Italy
Gust H. Bardy
Seattle Institute for Cardiac Research, Seattle, WA 98195, USA
Alessandro Capucci
Department of Biomedical Science and Public Health, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60020 Ancona, Italy
Background and Objectives: 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. Materials and Methods: 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. Results: 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 (p Conclusions: 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.
