Selective Coronary Angiography Following Cardiac Arrest

Sudden cardiac arrest is a major cause of death predominantly caused by ventricular tachyarrhythmia in patients with coronary artery disease. Despite advancements in resuscitation care, the rate of survival after cardiac arrest remains low. There is a growing body of observational data suggesting early coronary angiography reduces delay to revascularization and may improve outcomes. Most survivors present comatose, and neurologic outcome is uncertain; therefore it is often challenging to identify patients who will benefit from early coronary angiography. Several variables and risk scores that predict a favorable neurologic outcome have been identified. The rationale and current evidence for early angiography are reviewed, and a suggested approach to the selection of patients is presented.