Rhythm changes during resuscitation from ventricular fibrillation in relation to delay until defibrillation, number of shocks delivered and survival.

AIM To describe rhythm changes during the initial phase of resuscitation from ventricular fibrillation in relation to the interval between collapse and defibrillation, to survival and to bystander-initiated cardiopulmonary resuscitation (CPR). PATIENTS All patients who suffered out-of-hospital cardiac arrest between 1980 and 1992, who were reached by the emergency medical service system (EMS), in whom resuscitation attempts were initiated and who were found in ventricular fibrillation. RESULTS In all, 1216 patients were included in the study. Among patients who converted to a pulse-generating rhythm after the first defibrillation (n = 119) were 56% discharged from hospital as compared with 6% among patients who converted to asystole. The corresponding figures after the third defibrillation were 49% and 2%, respectively, and after the fifth defibrillation 28% and 7%, respectively. Among patients in whom the first defibrillation took place less than 5 min after collapse, 28% directly converted to a pulse-generating rhythm as compared with 3% when the first defibrillation took place 12 min or more after collapse. CONCLUSION Among patients who suffer out-of-hospital cardiac arrest and are found in ventricular fibrillation, there is a strong relationship between survival and initial rhythm changes after defibrillation. These rhythm changes are directly related to the interval between collapse and the first defibrillation.

[1]  L. Ekström,et al.  Hospital mortality after out-of-hospital cardiac arrest among patients found in ventricular fibrillation. , 1995, Resuscitation.

[2]  L. Ekström,et al.  Effect of bystander initiated cardiopulmonary resuscitation on ventricular fibrillation and survival after witnessed cardiac arrest outside hospital. , 1994, British heart journal.

[3]  A Hallstrom,et al.  Cardiac resuscitation in the community. Importance of rapid provision and implications for program planning. , 1979, JAMA.

[4]  M. Eisenberg,et al.  Prehospital cardiopulmonary resuscitation. Is it effective , 1985 .

[5]  L. Ekström,et al.  Survival after cardiac arrest outside hospital over a 12-year period in Gothenburg. , 1994, Resuscitation.

[6]  L. Ekström,et al.  Survival in patients found to have ventricular fibrillation after cardiac arrest witnessed outside hospital. , 1994, European heart journal.

[7]  M. Copass,et al.  Factors influencing survival after out-of-hospital cardiac arrest. , 1986, Journal of the American College of Cardiology.

[8]  R O Cummins,et al.  Survival of out-of-hospital cardiac arrest with early initiation of cardiopulmonary resuscitation. , 1985, The American journal of emergency medicine.

[9]  C. Case,et al.  Rhythm changes during resuscitation from ventricular fibrillation. , 1993, Resuscitation.

[10]  S. Goldstein,et al.  Characteristics of the Resuscitated Out‐of‐hospital Cardiac Arrest Victim with Coronary Heart Disease , 1981, Circulation.

[11]  E. John Gallagher,et al.  Effectiveness of Bystander Cardiopulmonary Resuscitation and Survival Following Out-of-Hospital Cardiac Arrest , 1995 .

[12]  L. Ekström,et al.  Type of arrhythmia at EMS arrival on scene in out-of-hospital cardiac arrest in relation to interval from collapse and whether a bystander initiated CPR. , 1996, The American journal of emergency medicine.

[13]  A. Hallstrom,et al.  Cardiac Resuscitation in the Community , 1979 .