Prompt prediction of successful defibrillation from 1-s ventricular fibrillation waveform in patients with out-of-hospital sudden cardiac arrest

2010 ◽  
Vol 25 (1) ◽  
pp. 34-41 ◽  
Author(s):  
Hiroshi Endoh ◽  
Seiji Hida ◽  
Satomi Oohashi ◽  
Yusuke Hayashi ◽  
Hidenori Kinoshita ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Sudden Cardiac Arrest

scholarly journals The dependence of successful resuscitation on electrocardiographically documented cardiac rhythm in case of out-of-hospital cardiac arrest

Medicina ◽  
2007 ◽  
Vol 43 (10) ◽  
pp. 798 ◽  
Author(s):  
Nedas Jasinskas ◽  
Dinas Vaitkaitis ◽  
Vidas Pilvinis ◽  
Lina Jančaitytė ◽  
Gailutė Bernotienė ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Cardiac Rhythm ◽  
Sudden Cardiac Arrest ◽  
Spontaneous Circulation ◽  
Consensus Conference ◽  
Successful Resuscitation ◽  
Initial Rhythm ◽  
Hospital Deaths ◽  
One Year

Objective. To determine the influence of electrocardiographically documented cardiac rhythm during sudden cardiac arrest on successful resuscitation among out-of-hospital deaths in Kaunas city. Material and methods. An observational prospective study was conducted between 1 January, 2005, and 30 December, 2005, in Kaunas city with a population of 360 627 inhabitants. In this period, all cases of cardiac arrest were analyzed according to the guidelines of the Utstein consensus conference. Cardiac arrest (both of cardiac and noncardiac etiology) was confirmed in 72 patients during one year. Effective cardiopulmonary resuscitation was performed in 18 patients. Results. The total number of deaths from all causes in Kaunas during 1-year study period was 6691. Sixty-two patients due to sudden death of cardiac etiology were resuscitated by emergency medical services personnel. Return of spontaneous circulation was achieved in 11 patients. Ventricular fibrillation was observed in 33 (53.2%) patients. Asystole was present in 11 (17.7%) and other rhythms in 18 (29.1%) cases. Patients with ventricular fibrillation as an initial rhythm were more likely to be successfully resuscitated than patients with asystole. Conclusions. Ventricular fibrillation was the most common electrocardiographically documented cardiac rhythm registered during cardiac arrest in out-of-hospital settings. Ventricular fibrillation as a mechanism of cardiac arrest was associated with major cases of successful resuscitation.

scholarly journals P059: Paramedic compliance with a novel defibrillation strategy in a large, urban EMS system in the United States

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S98
Author(s):  
J.M. Goodloe ◽  
L.D. Vinson ◽  
M.L. Cox ◽  
B.D. Burns
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Sudden Cardiac Arrest ◽  
The United States ◽  
Energy Strategy ◽  
Specific Analysis ◽  
Hands On ◽  
Software Code

Introduction: Emergency Medical Services (EMS) care confers distinct impact upon survivability from sudden cardiac arrest. Many studies have been conducted regarding EMS interventions for cardiac arrest, though fewer studies have been published detailing specific analysis of paramedic compliance with standing orders, particularly those involving a novel energy strategy in defibrillation. Methods: Adults in sudden cardiac arrest with resuscitation initiated, including at least one defibrillation, between July 1, 2016 and December 1, 2016 were enrolled. Education on a novel defibrillation strategy, involving weight-based joule settings and double sequential external defibrillation (DSED) was delivered in classroom and internet-accessed settings. Paramedics then performed hands-on practice in DSED. All resuscitations were reviewed from electronic medical records (EMRs) completed by treating paramedics, alongside telemetry and defibrillation events recorded, transmitted, and analyzed in proprietary software (CODE-STAT™, Physio-Control Corporation, Redmond, WA). All ECGs and defibrillation events were reviewed by an emergency physician to determine energy settings used by paramedics for determining the accuracy of compliance with protocol-based standing orders. Results: During the 5 month study period, the paramedics involved treated 133 adults in sudden cardiac arrest involving perceived ventricular fibrillation that was treated with at least one defibrillation. 76/90 (84.4%) with estimated weight <100 kg were treated with correct joule settings, though only 7/43 (16.3%) with estimated weight ≥100kg received all defibrillations at 360J as protocol-specified. 26/44 (59.1%) in refractory ventricular fibrillation, defined as requiring a fourth defibrillation, received DSED as protocol-specified. Conclusion: Paramedics, when specifically trained on a novel defibrillation strategy, involving both weight-based joule settings and use of DSED for refractory ventricular fibrillation, are inconsistently able to quickly and successfully incorporate that strategy in EMS resuscitation care. Further educational endeavours are warranted to achieve higher defibrillation strategy protocol compliance.

Abstract 55: Ventricular Fibrillation remains the Primary Presenting Rhythm: Results from the Wearable Cardioverter Defibrillator Human Study

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Hao Wang ◽  
Wanchun Tang ◽  
Min-Shan Tsai ◽  
Yongqin Li ◽  
Max H Weil
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Clinical Studies ◽  
Human Study ◽  
Sudden Cardiac Arrest ◽  
Pulseless Electrical Activity ◽  
Progressive Decrease ◽  
Cardioverter Defibrillator ◽  
Wearable Cardioverter Defibrillator ◽  
Initial Rhythm

Background. Clinical studies during the last 2 decades have demonstrated a progressive decrease in the incidence of ventricular fibrillation (VF) as the presenting rhythm in settings of out-of-hospital sudden cardiac arrest (SCA). In the present study, we investigated the initial rhythm of SCA from data recorded in a wearable cardioverter defibrillator (WCD) which collected these events in real time. Hypothesis. In settings of out-of-hospital SCA, VF remains the leading cause. Methods and Results. The incidence and the type of arrhythmias were determined by reviewing stored electrocardiograms in the WCDs. Seventy-four consecutive WCD recipients and 108 events were analyzed. Patients with a previously implanted ICD that required change due to infection were the most prevalent recipients of WCDs. Fifty-one percent were VF/VT patients and 43.8% were pulseless electrical activity (PEA) patients. VF/VT was the initial rhythm of SCA in 79.7% of patients and 86.1% of events while the PEA occurred in 20.3% of patients and 13.9% of events. 84.5% of patients survived VF/VT and 18.8% of patients survived PEA. There was no difference in the characteristics of patients with different initial rhythms. Conclusions. In out-of-hospital settings, VF remains the predominant initial rhythm when recorded immediately following SCA. .

Abstract 13358: Pediatric Defibrillation; Safety and Efficacy of Shocks in Both Ventricular Fibrillation and Sinus Rhythm in a Porcine Model

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Ben McCartney ◽  
Adam Harvey ◽  
Amy Kernaghan ◽  
Sara Morais ◽  
Olibhear McAlister ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Sinus Rhythm ◽  
Porcine Model ◽  
Sudden Cardiac Arrest ◽  
Left Ventricular ◽  
Safety And Efficacy ◽  
Automated External Defibrillators ◽  
Significant Difference ◽  
Post Shock

Introduction: Pediatric sudden cardiac arrest may require the delivery of a defibrillating shock to promote return of spontaneous circulation (ROSC). Fear of harm is a barrier for the use of automated external defibrillators by lay personnel, particularly when the patient is a child. The aim of this study was to observe the effects of delivering pediatric defibrillation shocks to pediatric weight swine who are in a perfusing rhythm or ventricular fibrillation (VF). Methods: Eight swine (10.3-26.8 kg) were studied under anesthesia. Up to 30 shocks were applied using modified samaritan AEDs (HeartSine, UK) to animals either in sinus rhythm or after 30 seconds of VF. Shocks delivered in sinus rhythm were unsynchronized. Four different shock types were applied, utilizing two different waveforms (Waveform-A at 50 J, Waveform-A at 75 J, Waveform-A at 90J and Waveform-B at 50 J). Left ventricular (LV) pressures were recorded invasively (Millar, USA). If the shock was successful, the animal entered a rest period of approximately 5 minutes, after which the next shock was applied. Results: Data presented in Table 1. Out of a total of 77 shocks delivered in sinus rhythm, 2 (2.6%) resulted in conversion to a cardiac arrest rhythm. Analysis of LV pressures demonstrated no significant differences in the change of LV dP/dt from baseline at 1, 10 and 60 seconds post-shock. There was no significant difference in shock success or ROSC between the shock types for defibrillation of VF. Analysis of LV pressures demonstrated no significant differences in the change of LV dP/dt from baseline at at 1, 10 and 60 seconds post-shock between the groups. Conclusions: The results of this study indicate defibrillation shocks applied to swine in sinus rhythm rarely result in conversion to an arrhythmia. Additionally, the variety of shock types demonstrated similar levels of safety and efficacy in this porcine model.

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