Study Objective: Effectiveness of a resuscitation strategy may vary across communities. We hypothesize that a strategy that prioritizes initial emergency medical services (EMS) rhythm analysis (analyze early) will be associated with survival advantage among EMS systems with lower baseline (pretrial) ventricular fibrillation survival, whereas a strategy that prioritizes initial EMS cardiopulmonary resuscitation (analyze late) will be associated with survival advantage among systems with higher ventricular fibrillation baseline survival.
Methods: We conducted a secondary, post hoc study of a randomized trial of out-of-hospital cardiac arrest. Subjects were stratified according to randomization status (analyze early versus analyze late) and EMS agency baseline ventricular fibrillation survival. We used a mixed-effects model to determine whether the association between favorable functional survival to hospital discharge and trial intervention (analyze late versus analyze early) differed according to EMS agency baseline ventricular fibrillation survival (<20% or >20%).
Results: Characteristics were similar among patients randomized to analyze early (n=4,964) versus analyze late (n=4,426). For EMS agencies with baseline ventricular fibrillation survival less than 20%, analyze late compared with analyze early was associated with a lower likelihood of favorable functional survival (3.8% versus 5.5%; odds ratio [OR]=0.67 [95% CI 0.50, 0.90]). Conversely, among agencies with a ventricular fibrillation survival greater than 20%, analyze late compared with analyze early was associated with higher likelihood of favorable functional survival (7.5% versus 6.1%; OR=1.22 [95% CI 0.98, 1.52]). In the multivariable-adjusted model, for every 10% increase in baseline ventricular fibrillation survival, analyze late versus analyze early was associated with a 34% increase in odds of favorable functional survival (OR=1.34 [95% CI 1.07 to 1.66]).
Conclusion: The findings suggest that system-level characteristics may influence resuscitation outcomes.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4196855 | PMC |
| http://dx.doi.org/10.1016/j.annemergmed.2014.01.014 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
BTKi-induced cardiovascular toxicity in CLL: Risk mitigation and management strategies.
Blood Rev
January 2025
Clinic of Hematology, University Clinical Centre of Serbia, Serbia; Faculty of Medicine, University of Belgrade, Serbia. Electronic address:
Targeted therapies, consisting of Bruton tyrosine kinase inhibitors (BTKis) or BCL-2 inhibitors, are the mainstay of contemporary treatments for chronic lymphocytic leukemia (CLL). The most common adverse effects (AEs) of BTKis are fatigue, bruising, infection, hematological and cardiovascular AEs. While AEs during treatment are usually mild (grades 1 and 2), grade 3 and 4 AEs have been detected in some patients, necessitating additional medical care and temporary or permanent drug discontinuation.
View Article and Find Full Text PDF[Catheter ablation in patients with heart failure-who benefits?].
Herzschrittmacherther Elektrophysiol
January 2025
Klinik für Elektrophysiologie/Rhythmologie, Ruhr-Universität Bochum, Bochum, Deutschland.
Atrial fibrillation (AF) ablation is associated with a lower likelihood of death and surgical heart failure (HF) interventions in patients with HF. This effect is mainly driven by reduced all cause and cardiovascular death following ablation. Ablation also results in improved left ventricular (LV) function, decreased AF burden and AF regression.
View Article and Find Full Text PDFPredictive Value of Left Atrial Strain for Thrombotic Events in Hypertrophic Cardiomyopathy without Atrial Fibrillation.
Radiol Cardiothorac Imaging
February 2025
From the Department of Cardiology (L.P., W.J., J.L., W.Q., Y.X., Y.K., Q.Z., Y.C.), Department of Geriatrics (K.W.), and Center of Rare Diseases (Y.C.), West China Hospital, Sichuan University, No. 37, Guo Xue Road, Chengdu, Sichuan 610041, China; and Wexner Medical Center, College of Medicine, The Ohio State University, Columbus, Ohio (Y.H.).
Purpose To assess the predictive value of left atrial (LA) fast long-axis strain derived from cardiac MRI for thrombotic events (TEs) in individuals with hypertrophic cardiomyopathy (HCM). Materials and Methods This secondary analysis of an ongoing prospective trial (Chinese Clinical Trial Registry: ChiCTR1900024094) included consecutive participants with HCM without atrial fibrillation (AF) who underwent cardiac MRI from January 2012 to December 2020. The LA fast long-axis strain was obtained by semiautomatically tracking the distance between the atrioventricular junction and the midposterior LA wall.
View Article and Find Full Text PDFTemporary mechanical circulatory support utilization and outcomes in cardiogenic shock phenotypes: A comparative analysis of heart failure and acute myocardial infarction.
Cardiovasc Revasc Med
January 2025
Department of Cardiovascular disease, Henry Ford, Detroit, MI, USA.
Introduction: Cardiogenic shock (CS) is marked by substantial morbidity and mortality. The two major CS etiologies include heart failure (HF) and acute myocardial infarction (AMI). The utilization trends of mechanical circulatory support (MCS) and their clinical outcomes are not well described.
View Article and Find Full Text PDFCardioesophageal Reflex. Should it trigger clinician's response?
Am J Med
January 2025
Professor of Medicine, Department of Cardiology, Tufts Medical Center, (Tufts University School of Medicine), Boston, MA 02111, USA. Electronic address:
Cardiologists and gastroenterologists often encounter the coexistence of symptoms and functional abnormalities, but determining causation is more difficult. In 1962 Smith and Papp first coined the term "linked angina". Their statement was preceded by the experiment whereby increase in bile duct pressure elicited the typical chest pain in patients with ischemic heart disease.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!