The Evolving Role of the Cardiac Catheterization Laboratory in the Management of Patients With Out-of-Hospital Cardiac Arrest: A Scientific Statement From the American Heart Association

Cardiac catheterization procedures have rapidly evolved and expanded in scope and techniques over the past few decades. However, although some practices have emerged based on evidence, many traditions have persisted based on beliefs and theoretical concerns. The aim of this review is to highlight common preprocedure, intraprocedure, and postprocedure catheterization laboratory practices where evidence has accumulated over the past few decades to support or discount traditionally held practices.

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Out-of-Hospital Cardiac Arrest Resuscitation Systems of Care: A Scientific Statement From the American Heart Association

Circulation ◽

10.1161/cir.0000000000000557 ◽

2018 ◽

Vol 137 (21) ◽

Cited By ~ 34

Author(s):

James J. McCarthy ◽

Brendan Carr ◽

Comilla Sasson ◽

Bentley J. Bobrow ◽

Clifton W. Callaway ◽

...

Keyword(s):

Cardiac Arrest ◽

American Heart Association ◽

American Heart ◽

Systems Of Care ◽

Heart Association ◽

Scientific Statement ◽

Hospital Cardiac Arrest

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The Reinvention of the American Heart Association and the Invention of Cardiac Catheterization

10.1093/med/9780199982356.003.0008 ◽

2015 ◽

Author(s):

W. Bruce Fye

Keyword(s):

World War Ii ◽

Cardiac Catheterization ◽

American Heart Association ◽

American Heart ◽

Heart Association ◽

Cardiovascular Research ◽

Catheterization Laboratory ◽

Cardiac Catheterization Laboratory ◽

National Heart ◽

Health Organization

President Harry Truman signed the National Heart Act in 1948, which resulted in the creation of the National Heart Institute and started federal funds flowing to academic centers to support cardiovascular research. Mayo cardiologist Arlie Barnes’s term as president of the American Heart Association coincided with its transformation from a low-budget professional society into a large voluntary health organization that raised funds from the public to support its programs. World War II research into shock contributed to the development of cardiac catheterization as a clinical diagnostic tool. Mayo’s wartime research program that focused on ways to protect fighter pilots from blackouts due to high gravitational forces led to the invention of technologies to measure blood pressure and blood oxygen content. Physiologist Earl Wood used these tools in Mayo’s cardiac catheterization laboratory, which was established at the institution in 1947. The clinic helped pioneer the emerging field of cardiac catheterization.

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Abstract 10476: Patient Characteristics and Survival Outcomes of Cardiac Arrest in the Cardiac Catheterization Laboratory: Insights from Get with the Guidelines-Resuscitation Registry

Circulation ◽

10.1161/circ.144.suppl_2.10476 ◽

2021 ◽

Vol 144 (Suppl_2) ◽

Author(s):

Ahmed Elkaryoni ◽

John J Lopez ◽

Paul S Chan

Keyword(s):

Cardiac Arrest ◽

Cardiac Catheterization ◽

Odds Ratio ◽

American Heart ◽

Patient Characteristics ◽

Lower Survival Rate ◽

Catheterization Laboratory ◽

Cardiac Catheterization Laboratory ◽

Get With The Guidelines ◽

Hospital Cardiac Arrest

Background: The characteristics and outcomes of in-hospital cardiac arrest (IHCA) in the cardiac catheterization laboratory (CCL) have not been well-described. We compared the characteristics and outcomes of patients with an IHCA in the CCL versus those in the operating room (OR) and the intensive care unit (ICU). Methods: Within the American Heart Association’s Get With the Guidelines-Resuscitation® registry, we identified patients 18 years of age or older with an IHCA in the CCL, OR, or ICU between 2000 and 2019. We compared rates of survival to discharge for patients in the CCL, OR, and ICU. Additionally, we examined predictors of survival to discharge for patients with IHCA in the CCL. Results: There were 6866, 5181, and 181,832 patients with an IHCA in the CCL, OR, and ICU, respectively. Patients with IHCAs in the CCL were more likely to have a shockable cardiac arrest rhythm as compared with those in the OR and ICU. Overall, 2614 (38.1%) patients with IHCA in the CCL survived to discharge, as compared with 30,833 (16.9%) from the ICU and 2096 (40.5%) from the OR. After adjustment for 27 patient and cardiac arrest factors, patients with IHCA in CCL were more likely to survive to discharge as compared with those with IHCA from the ICU (odds ratio, 1.37 [95% CI: 1.29-1.46], p<0.001). In contrast, they were less likely to survive to discharge as compared with those with IHCA in the OR (odds ratio, 0.81 [95% CI: 0.69-0.94], p=0.006). Predictors of survival to discharge in patients with IHCA in the CCL included white race, pulseless ventricular tachycardia/fibrillation, and IHCA during normal hours and on weekdays, while having myocardial infarction during this or prior hospitalization was associated with less survival to discharge. (Table). Conclusion: IHCA in the CCL is not uncommon and has a lower survival rate as compared with IHCA in other procedural areas such as the OR. The reasons for this difference deserve further study given that response to IHCAs in both settings should be similar.

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The role of endomyocardial biopsy in the management of cardiovascular disease: a Scientific Statement from the American Heart Association, the American College of Cardiology, and the European Society of Cardiology

European Heart Journal ◽

10.1093/eurheartj/ehn189 ◽

2008 ◽

Vol 29 (13) ◽

pp. 1696-1696 ◽

Cited By ~ 6

Author(s):

L. Anderson ◽

D. Pennell

Keyword(s):

Cardiovascular Disease ◽

European Society ◽

Endomyocardial Biopsy ◽

American Heart Association ◽

American Heart ◽

Heart Association ◽

Scientific Statement ◽

European Society Of Cardiology

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Post out-of-hospital cardiac arrest care in a tertiary care center in southern Thailand: From emergency department to intensive care unit

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907919830896 ◽

2019 ◽

Vol 27 (3) ◽

pp. 155-161 ◽

Cited By ~ 1

Author(s):

Veerapong Vattanavanit ◽

Supattra Uppanisakorn ◽

Thanapon Nilmoje

Keyword(s):

Intensive Care Unit ◽

Cardiac Arrest ◽

Intensive Care ◽

American Heart Association ◽

American Heart ◽

Medical Intensive Care Unit ◽

Heart Association ◽

Temperature Management ◽

Medical Intensive Care ◽

Hospital Cardiac Arrest

Background: Out-of-hospital cardiac arrest results in a high mortality rate. The 2015 American Heart Association guideline for post-cardiac arrest was launched and adopted into our institutional policy. Objectives: We aimed to evaluate post-cardiac arrest care and compare the results with the 2015 American Heart Association guideline and clinical outcomes of out-of-hospital cardiac arrest patients. Methods Included in this study were all adult patients who survived out-of-hospital cardiac arrest and were admitted to the Medical Intensive Care Unit of Songklanagarind Hospital, Thailand. The retrospective review was from 1 January 2016 to 31 December 2017. Results: From a total of 161 post-cardiac arrest patients admitted to the medical intensive care unit, 69 out-of-hospital cardiac arrest patients were identified. The most common cause of arrest was presumed cardiac in origin (45.0%) in which the majority was acute myocardial infarction (67.8%). Coronary intervention and targeted temperature management were performed in 27.5% and 13% of all out-of-hospital cardiac arrest patients, respectively. Survival to hospital discharge was 42%. Independent factors associated with survival to discharge were shockable rhythms, lower adrenaline doses, and the absence of hypotension at medical intensive care unit admission. Conclusion: Compliance with the 2015 American Heart Association post-cardiac arrest care guideline was low in our institution, especially in coronary intervention and targeted temperature management.

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2019 American Heart Association Focused Update on Systems of Care: Dispatcher-Assisted Cardiopulmonary Resuscitation and Cardiac Arrest Centers: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

Circulation ◽

10.1161/cir.0000000000000733 ◽

2019 ◽

Vol 140 (24) ◽

Cited By ~ 6

Author(s):

Ashish R. Panchal ◽

Katherine M. Berg ◽

José G. Cabañas ◽

Michael C. Kurz ◽

Mark S. Link ◽

...

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

American Heart Association ◽

American Heart ◽

Systems Of Care ◽

Heart Association ◽

Integrated System ◽

Care Chain ◽

Published Evidence ◽

Hospital Cardiac Arrest

Survival after out-of-hospital cardiac arrest requires an integrated system of care (chain of survival) between the community elements responding to an event and the healthcare professionals who continue to care for and transport the patient for appropriate interventions. As a result of the dynamic nature of the prehospital setting, coordination and communication can be challenging, and identification of methods to optimize care is essential. This 2019 focused update to the American Heart Association systems of care guidelines summarizes the most recent published evidence for and recommendations on the use of dispatcher-assisted cardiopulmonary resuscitation and cardiac arrest centers. This article includes the revised recommendations that emergency dispatch centers should offer and instruct bystanders in cardiopulmonary resuscitation during out-of-hospital cardiac arrest and that a regionalized approach to post–cardiac arrest care may be reasonable when comprehensive postarrest care is not available at local facilities.

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2019 American Heart Association Focused Update on Pediatric Advanced Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

Circulation ◽

10.1161/cir.0000000000000731 ◽

2019 ◽

Vol 140 (24) ◽

Cited By ~ 7

Author(s):

Jonathan P. Duff ◽

Alexis A. Topjian ◽

Marc D. Berg ◽

Melissa Chan ◽

Sarah E. Haskell ◽

...

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

American Heart Association ◽

Life Support ◽

American Heart ◽

Heart Association ◽

Targeted Temperature Management ◽

Temperature Management ◽

Liaison Committee ◽

Hospital Cardiac Arrest

This 2019 focused update to the American Heart Association pediatric advanced life support guidelines follows the 2018 and 2019 systematic reviews performed by the Pediatric Life Support Task Force of the International Liaison Committee on Resuscitation. It aligns with the continuous evidence review process of the International Liaison Committee on Resuscitation, with updates published when the International Liaison Committee on Resuscitation completes a literature review based on new published evidence. This update provides the evidence review and treatment recommendations for advanced airway management in pediatric cardiac arrest, extracorporeal cardiopulmonary resuscitation in pediatric cardiac arrest, and pediatric targeted temperature management during post–cardiac arrest care. The writing group analyzed the systematic reviews and the original research published for each of these topics. For airway management, the writing group concluded that it is reasonable to continue bag-mask ventilation (versus attempting an advanced airway such as endotracheal intubation) in patients with out-of-hospital cardiac arrest. When extracorporeal membrane oxygenation protocols and teams are readily available, extracorporeal cardiopulmonary resuscitation should be considered for patients with cardiac diagnoses and in-hospital cardiac arrest. Finally, it is reasonable to use targeted temperature management of 32°C to 34°C followed by 36°C to 37.5°C, or to use targeted temperature management of 36°C to 37.5°C, for pediatric patients who remain comatose after resuscitation from out-of-hospital cardiac arrest or in-hospital cardiac arrest.

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2019 American Heart Association Focused Update on Pediatric Basic Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

Circulation ◽

10.1161/cir.0000000000000736 ◽

2019 ◽

Vol 140 (24) ◽

Author(s):

Jonathan P. Duff ◽

Alexis A. Topjian ◽

Marc D. Berg ◽

Melissa Chan ◽

Sarah E. Haskell ◽

...

Keyword(s):

Systematic Review ◽

Cardiac Arrest ◽

American Heart Association ◽

Basic Life Support ◽

Life Support ◽

American Heart ◽

Heart Association ◽

Liaison Committee ◽

Bystander Cpr ◽

Hospital Cardiac Arrest

This 2019 focused update to the American Heart Association pediatric basic life support guidelines follows the 2019 systematic review of the effects of dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) on survival of infants and children with out-of-hospital cardiac arrest. This systematic review and the primary studies identified were analyzed by the Pediatric Task Force of the International Liaison Committee on Resuscitation. It aligns with the International Liaison Committee on Resuscitation’s continuous evidence review process, with updates published when the International Liaison Committee on Resuscitation completes a literature review based on new published evidence. This update summarizes the available pediatric evidence supporting DA-CPR and provides treatment recommendations for DA-CPR for pediatric out-of-hospital cardiac arrest. Four new pediatric studies were reviewed. A systematic review of this data identified the association of a significant improvement in the rates of bystander CPR and in survival 1 month after cardiac arrest with DA-CPR. The writing group recommends that emergency medical dispatch centers offer DA-CPR for presumed pediatric cardiac arrest, especially when no bystander CPR is in progress. No recommendation could be made for or against DA-CPR instructions when bystander CPR is already in progress.

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