Why the study?
Clinical features among patients with refractory out-of-hospital cardiac arrest and initial shockable rhythms of ventricular fibrillation/pulseless ventricular tachycardia are not well-characterized.
Are there differences in clinical features, angiographic findings, and in-hospital outcomes between patients with refractory versus non-refractory out-of-hospital cardiac arrest and an initial shockable rhythm?
Are there differences in clinical features, angiographic findings, and in-hospital outcomes between patients with refractory versus non-refractory out-of-hospital cardiac arrest and an initial shockable rhythm?
Refractory OHCA with an initial shockable rhythm is a high-risk condition associated with higher rates of acute coronary occlusion and worse in-hospital outcomes.
Refractory shockable OHCA warrants vigilant post-arrest care; leaves open optimal strategies pending prospective trials.
BACKGROUND: Clinical features among patients with refractory out-of-hospital cardiac arrest (OHCA) and initial shockable rhythms of ventricular fibrillation/pulseless ventricular tachycardia are not well-characterized. METHODS: We compared clinical characteristics and coronary angiographic findings between patients with refractory OHCA (incessant ventricular fibrillation/pulseless ventricular tachycardia after ≥3 direct-current shocks) and those without refractory OHCA. RESULTS: =0.034). CONCLUSIONS: Refractory ventricular fibrillation/pulseless ventricular tachycardia OHCA was associated with more intensive resuscitation, higher rates of acute coronary occlusion, and poorer in-hospital outcomes, underscoring the need for future studies in this extreme-risk subgroup.
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Zheng et al. (2023) studied this question.
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