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Joint British Societies’ guideline on management of cardiac arrest in the cardiac catheter laboratory
  1. Joel Dunning1,
  2. Andrew Archbold2,
  3. Joseph Paul de Bono3,
  4. Liz Butterfield4,
  5. Nick Curzen5,
  6. Charles D Deakin6,
  7. Ellie Gudde7,8,
  8. Thomas R Keeble7,8,
  9. Alan Keys9,
  10. Mike Lewis10,
  11. Niall O'Keeffe11,
  12. Jaydeep Sarma12,
  13. Martin Stout13,
  14. Paul Swindell14,
  15. Simon Ray12
  1. 1Department of Cardiothoracic Surgery, James Cook University Hospital, Middlesbrough, Middlesbrough, UK
  2. 2Department of General & Interventional Cardiology, Barts Heart Centre, St Bartholomew's Hospital, London, UK
  3. 3Department of Cardiology, Queen Elizabeth Hospital, University of Birmingham, Birmingham, West Midlands, UK
  4. 4School of Nursing, Midwifery and Social Work, Faculty of Health and Wellbeing, Canterbury Christ Church University, Canterbury, UK
  5. 5Faculty of Medicine, University of Southampton and Department of Cardiology, Southampton, UK
  6. 6Anaesthesia and Intensive Care, Southampton University Hospitals NHS Trust, Southampton, Southampton, UK
  7. 7Essex Cardiothoracic Centre, Mid and South Essex NHS Trust, Basildon, Essex, UK
  8. 8Medical Technology Research Centre, Anglia Ruskin School of Medicine, Chelmsford, UK
  9. 9Cardiovascular Care Partnership (UK), British Cardiovascular Society, London, London, UK
  10. 10Department of Cardiac Surgery, Royal Sussex County Hospital, Brighton, UK
  11. 11Department of Cardiothoracic Anaesthesia and Critical Care, Manchester University NHS Foundation Trust, Manchester, Greater Manchester, UK
  12. 12Department of Cardiology, Manchester University NHS Foundation Trust, Manchester, Greater Manchester, UK
  13. 13School of Healthcare Science, Manchester Metropolitan University, Manchester, UK
  14. 14Sudden Cardiac Arrest UK, UK
  1. Correspondence to Professor Simon Ray, Cardiology, Manchester University NHS Foundation Trust, Manchester, Greater Manchester, UK; simon.ray{at}


More than 300 000 procedures are performed in cardiac catheter laboratories in the UK each year. The variety and complexity of percutaneous cardiovascular procedures have both increased substantially since the early days of invasive cardiology, when it was largely focused on elective coronary angiography and single chamber (right ventricular) permanent pacemaker implantation. Modern-day invasive cardiology encompasses primary percutaneous coronary intervention, cardiac resynchronisation therapy, complex arrhythmia ablation and structural heart interventions. These procedures all carry the risk of cardiac arrest.

We have developed evidence-based guidelines for the management of cardiac arrest in adult patients in the catheter laboratory. The guidelines include recommendations which were developed by collaboration between nine professional and patient societies that are involved in promoting high-quality care for patients with cardiovascular conditions. We present a set of protocols which use the skills of the whole catheter laboratory team and which are aimed at achieving the best possible outcomes for patients who suffer a cardiac arrest in this setting. We identified six roles and developed a treatment algorithm which should be adopted during cardiac arrest in the catheter laboratory. We recommend that all catheter laboratory staff undergo regular training for these emergency situations which they will inevitably face.

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  • Correction notice This article has been corrected since it was first published due to the incorrect use of a pronoun in the final table of recommendations.

  • Contributors All authors contributed to the discussions of the Working Group, the drafting of the document and approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests JPdB is member of council for the British Heart Rhythm Society, a co-opted member of council for the Resuscitation Council UK, and a practising interventional cardiac electrophysiologist. EG received Abbott Vascular educational funding. SR is a trustee of Heart Valve Voice and Immediate Past President of the British Cardiovascular Society. NO is Immediate Past President for the Association for Cardiothoracic Anaesthesia and Critical Care. CD is on the Executive Committee for the Resuscitation Council UKALS Working Group, ILCOR. JS is lead of a non-profit cardiac catheter laboratory resuscitation educational programme based in Wythenshawe Hospital, Lead Cardiology Clinician, CLEMS course at Wythenshawe Hospital. AA is Vice President for Clinical Standards, British Cardiovascular Society. TK is an advisory board member of the Zoll Medical COOL AMI EU clinical study, received research funds to support cardiac arrest projects from Zoll, and received speaker fees from BD ( JD is co-founder of Cardiac Advanced Resuscitation Education ( which is a group that trains clinicians worldwide for emergencies in catheter laboratories, emergencies after cardiac surgery, and thoracic emergency department care. JD is Deputy Editor of, on the SCTS Thoracic Subcommittee, ISMICS Board of Directors 2017, and is STS Workforce Chairman for guideline for resuscitation after cardiac surgery. All other authors declare no competing interests.

  • Patient and public involvement Patients were involved in the design, conduct, and reporting, with dissemination, and two patients are co-authors of this guideline.

  • Provenance and peer review Commissioned; externally peer reviewed.

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