Key result
Cardiac arrest survivors with an ICD show similar discharge rates compared to non-arrest patients.
Why the study?
Little is known about the long-term outcome of ICD therapy in survivors of out-of-hospital cardiac arrest, including the frequency of lethal ventricular arrhythmias and whether ICD implantation can prevent cardiac arrest recurrence.
Cohort (n=58)
No
Answers are grounded in this paper and cite their sources.
May support ICD use to prevent recurrence in selected OHCA survivors; leaves open efficacy confirmation by randomized trials.
BACKGROUND: Little is known about the long-term outcome of implantable cardioverter defibrillator (ICD) therapy in survivors of out-of-hospital cardiac arrest (OHCA). METHODS AND RESULTS: The frequency of lethal ventricular arrhythmias and whether ICD implantation can prevent recurrence of cardiac arrest were examined. Long-term (24.4+/-11.9 months) outcome was examined in 23 patients with OHCA who were treated with an ICD (OHCA group) and 35 patients without OHCA (non-OHCA group) who were treated with an ICD. Patients in both groups had same clinical backgrounds; however, those in the OHCA group showed a significantly lower incidence of induced ventricular arrhythmias (71%) than the non-OHCA group (96%). In the follow-up period, patients in the OHCA group had almost the same incidence of ICD discharge (30%) as patients in the non-OHCA group (40%). The rate of recurrence of ventricular fibrillation in the OHCA patients was 13%, and it was difficult to estimate the rate by induced ventricular arrhythmia. CONCLUSION: The results suggest that ICD implantation for survivors of OHCA with favorable neurological recovery might be effective for preventing recurrence of cardiac arrest.
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Nagahara et al. (2006) conducted a cohort in Out-of-hospital cardiac arrest of cardiac origin and ventricular tachyarrhythmias treated with an implantable cardioverter defibrillator (n=58). Out-of-hospital cardiac arrest survivorship with ICD implantation vs. ICD implantation in patients without out-of-hospital cardiac arrest was evaluated on Implantable cardioverter defibrillator discharge for recurrent lethal ventricular arrhythmia (p=NS). Survivors of out-of-hospital cardiac arrest with an ICD had a similar rate of ICD discharge (30% vs 40%, p=NS) despite lower inducible arrhythmias (71% vs 96%, p<0.05) than non-arrest ICD patients.
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