Why the study?
Does tenecteplase improve myocardial perfusion as measured by AMSA and MF in patients with sustained VF during OHCA?
Observational (n=9)
Does tenecteplase improve myocardial perfusion as measured by AMSA and MF in patients with sustained VF during OHCA?
p-value: p=0.016
Administration of tenecteplase during CPR for sustained VF did not improve ECG markers of myocardial perfusion (AMSA and MF) and was associated with longer VF duration.
Tenecteplase during CPR for sustained VF was associated with longer VF without perfusion benefit; leaves open any role in OHCA pending randomized data.
BACKGROUND: Improved microcirculatory reperfusion in patients with ventricular fibrillation (VF) enhances the electrical activity of the fibrillation process and increases the likelihood of successful defibrillation. METHODS: Changes in amplitude spectrum area (AMSA) and mean fibrillation (MF) in patients with sustained VF were analysed after administration of rt-PA variant tenecteplase in out-of-hospital cardiac arrest (OHCA) during cardiopulmonary resuscitation (CPR). RESULTS: A total of 69 ECG sequences from nine patients were evaluated. Patients who received tenecteplase showed significantly longer duration of VF (p = 0.016). While AMSA declined significantly during CPR (p = 0.001), MF did not differ between groups. There were two survivors in the treatment group and one in the control group. CONCLUSION: When tenecteplase was administered during CPR, VF lasted significantly longer than in controls. Changes in MF and AMSA did not indicate improved myocardial perfusion in patients who received tenecteplase during CPR.
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Lederer et al. (2010) conducted an observational in Out-of-hospital cardiac arrest with sustained ventricular fibrillation (n=9). Tenecteplase vs. Control was evaluated on Duration of ventricular fibrillation (p=0.016).
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