Interventional cardiology surgery
Antiarrhythmic management and implantable defibrillator use in
survivors of prehospital cardiac arrest without myocardial infarction
in West Yorkshire
C B Peppera, P D Batinb, M Ryderc, J Bannisterc, J C Cowana, A F Mackintoshc
a Yorkshire Heart
Centre, Leeds General Infirmary, Great George St, Leeds LS1 3EX, West
Yorkshire, UK, b Pinderfields Hospital, Wakefield, West
Yorkshire, UK, c Department of
Cardiology, St James Hospital, Leeds, West Yorkshire, UK
Correspondence to: Dr Pepper
Accepted 9 September
1999
OBJECTIVE
To explore the current use
of secondary preventive treatment in survivors of out of hospital
cardiac arrest without myocardial infarction (primary ventricular
tachycardia/ventricular fibrillation (VT/VF)) in West Yorkshire, and
assess the implications of recent studies on the benefits of
implantable cardioverter-defibrillators (AICD) in this context.
DESIGNRetrospective analysis of an
ambulance service based database of outcome after resuscitation of out
of hospital cardiac arrest and the Leeds AICD implantation database.
MAIN OUTCOME MEASURESMortality, rate
of referral for specialist investigation, antiarrhythmic treatment.
RESULTSTwelve month mortality
following successful discharge after primary VF arrest was 15%. Of 53 patients with primary VF/VT, 29 apparently did not see a cardiologist
during the initial admission. Amiodarone was the most widely used
antiarrhythmic agent. Six patients (15%) received an AICD. During the
same period 22 patients from the same catchment area received an AICD
following an in-hospital cardiac arrest.
CONCLUSIONSMortality among survivors
of non-infarct related prehospital cardiac arrest remains significant,
with few patients being referred for specialist investigation. The
implementation of recent guidelines on AICD use in cardiac arrest
survivors would have resulted in an approximate 60% increase in the
total numbers of defibrillators implanted in the West Yorkshire area.
Keywords: ventricular fibrillation; ventricular tachycardia; primary arrhythmias; implantable cardioverter-defibrillator
© 2000 by Heart
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