scholarly journals High haemoglobin A1c level is a possible risk factor for ventricular fibrillation in sudden cardiac arrest among non-diabetic individuals in the general population

EP Europace ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. 394-400
Author(s):  
Laura H van Dongen ◽  
Marieke T Blom ◽  
Abdenasser Bardai ◽  
Paulien C M Homma ◽  
Joline W J Beulens ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Hba1c Level ◽  
Sudden Cardiac Arrest ◽  
Fold Increase ◽  
Glycated Haemoglobin ◽  
Haemoglobin A1c ◽  
Electrocardiogram Ecg ◽  
Control Study ◽  
Hba1c Levels

Abstract Aims This study aimed to establish whether higher levels of glycated haemoglobin (HbA1c) are associated with increased sudden cardiac arrest (SCA) risk in non-diabetic individuals. Methods and results Case–control study in non-diabetic individuals (HbA1c < 6.5%) in the Netherlands. Cases were SCA patients with electrocardiogram (ECG)-documented ventricular fibrillation (VF, the predominant cause of SCA) and HbA1c measurements immediately after VF, prospectively included in September 2009–December 2012. Controls (up to 10 per case) were age/sex-matched non-SCA individuals, included in July 2006–November 2007. We studied 306 cases (56.4 ± 6.8 years, 79.1% male) and 1722 controls (54.0 ± 6.8 years, 64.8% male). HbA1c levels were higher in cases than in controls (5.8 ± 0.3% vs. 5.4 ± 0.3%, P < 0.001). The proportion of increased HbA1c (≥5.7%) was 63.1% in cases and 19.3% in controls (P < 0.001). Multivariate regression models indicated that increased HbA1c was associated with a > six-fold increased VF risk [adjusted odds ratio (ORadj) 6.74 (5.00–9.09)] and that 0.1% increase in HbA1c level was associated with 1.4-fold increase in VF risk, independent of concomitant cardiovascular risk factors. Increased VF risk at higher HbA1c is associated with acute myocardial infarction (MI) as cause of VF [OR 1.14 (1.04–1.24)], but the association between HbA1c and VF was similar in non-MI patients [OR 1.32 (1.21–1.44)] and MI patients [OR 1.47 (1.37–1.58)]. Conclusion Among non-diabetic individuals, risk of VF increased with rising HbA1c levels, independent of concomitant cardiovascular disease. Future studies should establish whether HbA1c level may be used as biomarker to recognize individuals at risk for VF.

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.

HBA1C IS ASSOCIATED WITH FRAILTY IN A GROUP OF ABORIGINAL AUSTRALIANS

2018 ◽  
pp. 1-4
Author(s):  
Z. Hyde ◽  
K. Smith ◽  
L. Flicker ◽  
D. Atkinson ◽  
S. Fenner ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Hba1c Level ◽  
Binary Logistic Regression ◽  
Glycated Haemoglobin ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Aboriginal Australians ◽  
Obesity And Diabetes ◽  
Hba1c Levels

In this cross-sectional study of 141 Aboriginal Australians aged ≥45 years living in the remote Kimberley region of Western Australia, we explored whether glycated haemoglobin (HbA1c) levels were associated with frailty. Sixty-four participants (45.4%) had a HbA1c level ≥6.5% and 84 participants (59.6%) were frail. A significant trend was observed with regard to HbA1c levels and frailty, with those having HbA1c levels ≥6.5% having the greatest prevalence of frailty (70.3%). In binary logistic regression analyses, having a HbA1c level ≥6.5% was associated with being frail after adjustment for age, sex, and education. This association was attenuated after further adjustment for body mass index (BMI). Poorer glycaemic control is very common and a potential risk factor for frailty in remote-living Aboriginal Australians, and appears to be partly mediated by BMI, a known risk factor for diabetes mellitus. Obesity and diabetes mellitus are potentially important modifiable risk factors for frailty.

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 Factors associated with high levels of glycated haemoglobin in patients with type 1 diabetes: a multicentre study in Brazil

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018094 ◽  
Author(s):  
Carine Sousa Andrade ◽  
Guilherme Sousa Ribeiro ◽  
Carlos Antonio Souza Teles Santos ◽  
Raimundo Celestino Silva Neves ◽  
Edson Duarte Moreira
Keyword(s):  
Type 1 Diabetes ◽  
Glycaemic Control ◽  
Hba1c Level ◽  
Glycated Haemoglobin ◽  
Poor Adherence ◽  
Adherence To Diet ◽  
The Mean ◽  
Lower Education ◽  
Hba1c Levels

ObjectiveLong-term complications of type 1 diabetes mellitus (DM1) can be prevented with adequate glycaemic control. However, high levels of glycated haemoglobin (HbA1c) occur in 60%–90% of the patients with DM1. Thus, we aimed to investigate the role of sociodemographic, behavioural and clinical factors on the HbA1c levels of patients with DM1 in Brazil.Design, setting and participantsA cross-sectional study was conducted in ambulatory patients with DM1 aged ≥18 years from 10 Brazilian cities. Sociodemographic, behavioural and clinical data were obtained through interviews.Main outcome measuresHbA1c level was measured by liquid chromatography. Hierarchical multiple variable linear regression models were used to identify factors correlated with high levels of HbA1c.ResultsOf 979 patients with DM1, 63.8% were women, and the mean age was 40 (SD 14.6) years. The mean HbA1c level was 9.4% (SD 2.2%), and 89.6% of the patients had HbA1c ≥7.0%. Factors independently correlated with increased HbA1c levels included: lower education, non-participation in diabetes classes/lecture during the year before, having a self-perception of poor adherence to diet and insulin, not having private medical care and not measuring the HbA1c levels in the prior year. Of note, poor adherence to diet and insulin were the independent factors most strongly associated with high levels of HbA1c (mean increment in HbA1c levels of 0.88% and 1.25%, respectively).ConclusionPoor glycaemic control, which is common among Brazilian patients with DM1, is associated with lower education, self-perception of insufficient adherence to diet and insulin and inadequate monitoring of HbA1c levels. Specific actions, particularly those targeting improving adherence to diet and insulin, may contribute to successful management of patients with DM1.

Idiopathic ventricular fibrillation: the ongoing quest for diagnostic refinement

EP Europace ◽  
2020 ◽  
Author(s):  
Giulio Conte ◽  
John R Giudicessi ◽  
Michael J Ackerman
Keyword(s):  
Ventricular Fibrillation ◽  
Heart Diseases ◽  
Sudden Cardiac Arrest ◽  
Polymorphic Ventricular Tachycardia ◽  
Molecular Evidence ◽  
Idiopathic Ventricular Fibrillation ◽  
Diagnostic Approaches ◽  
Exercise Induced ◽  
Definition Of ◽  
Electrocardiogram Ecg

Abstract Prior to the recognition of distinct clinical entities, such as Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, and long QT syndrome, all sudden cardiac arrest (SCA) survivors with ventricular fibrillation (VF) and apparently structurally normal hearts were labelled as idiopathic ventricular fibrillation (IVF). Over the last three decades, the definition of IVF has changed substantially, mostly as result of the identification of the spectrum of SCA-predisposing genetic heart diseases (GHDs), and the molecular evidence, by post-mortem genetic analysis (aka, the molecular autopsy), of cardiac channelopathies as the pathogenic basis for up to 35% of unexplained cases of sudden cardiac death (SCD) in the young. The evolution of the definition of IVF over time has led to a progressively greater awareness of the need for an extensive diagnostic assessment in unexplained SCA survivors. Nevertheless, GHDs are still underdiagnosed among SCA survivors, due to the underuse of pharmacological challenges (i.e. sodium channel blocker test), misrecognition of electrocardiogram (ECG) abnormalities/patterns (i.e. early repolarization pattern or exercise-induced ventricular bigeminy) or errors in the measurement of ECG parameters (e.g. the heart-rate corrected QT interval). In this review, we discuss the epidemiology, diagnostic approaches, and the controversies related to role of the genetic background in unexplained SCA survivors with a default diagnosis of IVF.

scholarly journals Increased Risk of Sudden Cardiac Arrest in Obstructive Pulmonary Disease: A Case-Control Study

PLoS ONE ◽  
2013 ◽  
Vol 8 (6) ◽  
pp. e65638 ◽  
Author(s):  
Miriam Jacoba Warnier ◽  
Marieke Tabo Blom ◽  
Abdennasser Bardai ◽  
Jocelyn Berdowksi ◽  
Patrick Cyriel Souverein ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Pulmonary Disease ◽  
Case Control Study ◽  
Sudden Cardiac Arrest ◽  
Case Control ◽  
Obstructive Pulmonary Disease ◽  
Increased Risk ◽  
Control Study

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.

scholarly journals Factors Associated with High-Quality Cardiopulmonary Resuscitation Performed by Bystander

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Hye Ji Park ◽  
Won Jung Jeong ◽  
Hyung Jun Moon ◽  
Gi Woon Kim ◽  
Jin Seong Cho ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Life Support ◽  
Age Groups ◽  
Sudden Cardiac Arrest ◽  
Advanced Life Support ◽  
Fold Increase ◽  
High Quality ◽  
Neurological Outcomes ◽  
Bystander Cpr ◽  
Cpr Quality

Bystander cardiopulmonary dresuscitation (CPR) improves the survival and neurological outcomes of sudden cardiac arrest patients. The rate of bystander CPR is increasing; however, its performance quality has not been evaluated in detail. In this study, emergency medical technicians (EMTs) in the field evaluated bystander CPR quality, and we aimed to investigate the association between bystander information and CPR quality. This retrospective cohort study was based on data included in the Smart Advanced Life Support (SALS) registry between January 2016 and December 2017. We included patients older than 18 years who experienced an out-of-hospital cardiac arrest (OHCA) due to medical causes. Bystander CPR quality was judged to be “high” when the hand positions were appropriate and when compression rates of at least 100/min and compression depths of at least 5 cm were achieved. Among 6,769 eligible patients, 3,799 (58.7%) received bystander CPR, and 6% of bystanders performed high-quality CPR. After adjustment, the occurrence of cardiac arrest at home (adjusted odds ratio (aOR), 95% confidence interval (CI); 0.42, 0.27–0.64), witnessed cardiac arrest (1.45, 1.03–2.06), and younger bystander age all showed associations with one another. High-quality CPR led to a 4.29-fold increase in the chance of neurological recovery. In particular, high-quality CPR in patients aged 60 years showed a significant association compared with other age groups (7.61, 1.41–41.04). The main factor affecting CPR quality in this study was the age of the bystander, and older bystanders found it more difficult to maintain CPR quality. To improve the quality of bystander CPR, training among older bystanders should be the focus.

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