Abstract 283: Cardiac Functional Recovery At One Year In Refractory Out-of-hospital Cardiac Arrest Survivors

Introduction: The survival to discharge of patients presenting with refractory out-of-hospital cardiac arrest (OHCA) in centers with a well-established extracorporeal cardiopulmonary resuscitation (ECPR) program has improved over the last decade. While quality of life is an important consideration for all survivors, long-term cardiac functional recovery as defined by the New York Heart Association (NYHA) of this population remains unknown. Methods: We performed a single center, retrospective analysis to evaluate the functional cardiac recovery of refractory OHCA survivors receiving ECPR with VA-ECMO between 2016 and 2020. Relevant demographic information as well as data on admission characteristics and index hospitalization were collected (Table). NYHA functional class was assessed at one month and at one year after hospital discharge. All patients had a transthoracic echocardiogram before discharge. Results: We identified 54 patients that were discharged following ECPR for OHCA during the study period. Forty-six (85%) were alive at one year. Complete functional outcome data were available for 37 survivors. Compared to the first assessment at 1 month, 15 patients (41%) had symptomatic improvement of at least one NYHA class at 1 year ( Figure ). No patients experienced clinical deterioration. Left ventricular ejection fraction assessed pre-discharge was the only significantly different parameter between those with improved and unchanged NYHA class at one year ( Table ). Conclusions: A large proportion of refractory OHCA survivors treated with ECPR have substantial improvement in their NYHA functional status at 1 year.