Abstract 296: Determinants of Incidence of Ventricular Fibrillation as First Recorded Rhythm During Out-of-Hospital Cardiac Arrest and Association with Long-Term Neurological Outcomes: Observations from a Large Randomized Clinical Study

• Published in: Circulation (New York, N.Y.) N.Y.), 2012-11, Vol.126 (suppl_21)
• Main Authors: Yannopoulos, Demetris, Holcomb, Richard, Frascone, Ralph J, Mahoney, Brian D, Wayne, Marvin A, Swor, Robert A, Domeier, Robert M, Olinger, Michael L, Tupper, David E, Aufderheide, Tom P
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.126.suppl_21.A296

Abstract only Background: We sought to identify the factors that were associated with higher incidence of VF and survival with good neurological function in the ResQ Trial patients that compared standard cardiopulmonary resuscitation (S-CPR) versus active compression decompression CPR with an inspiratory impedance threshold device (ACD+ITD) in patients with out of hospital cardiac arrest (OHCA). Methods: A retrospective analysis of a randomized multicenter clinical study of 1655 patients with OHCA. 88.3% (106/120) of the patients discharged with good neurological function [Modified Rankin Score (MRS)≤3] had a first recorded rhythm of ventricular fibrillation/pulseless ventricular tachycardia (VF). The first rhythm was recorded in 99.4% (1645/1655) of the cases about 9.5 minutes after 911 call, on average 3 minutes after the arrival of EMS on the scene and after CPR was performed for at least 2 minutes. Results: A total of 32.8% of the patients had VF as presenting rhythm and 42.8% received bystander CPR. Presence of bystander CPR was associated with a higher VF incidence only in the S-CPR group (40.8% versus 23.1% with no bystander, p=0.001) but survival was 7.6% versus 4.6% p=0.09. Presence or absence of bystander CPR let to similar VF incidence and survival in the ACD+ITD group 36.1% versus 33.9% and 9.0% versus 8.9% respectively, p>0.2. After propensity adjustment for witnessed arrest, age