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Clinical Analysis of Prehospital Heartsavers Surviving Out-of-hospital Cardiac Arrest of Cardiac Origin
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¹Ú°æÀÎ(Park Kyung-In) - ´ë±¸°¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ÀÀ±ÞÀÇÇб³½Ç
±è±Õ¹«(Kim Gyun-Moo) - ´ë±¸°¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ÀÀ±ÞÀÇÇб³½Ç
ÀåÅÂâ(Jang Tae-Chang) - ´ë±¸°¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ÀÀ±ÞÀÇÇб³½Ç
Abstract
Purpose: Sudden cardiac death is still a major cause ofdeath and a burden to national public health. Out-of-hospitalcardiac arrest (OHCA) patients achieving field Return ofspontaneous circulation (ROSC) have better survival ratesand good neurological outcomes. The study was designedfor analysis of prehospital and hospital clinical characteristicsof Heartsaver patients surviving OHCA of cardiac origin.
Methods: A retrospective study was conducted on 31Heartsaver patients surviving OHCA by EmergencyMedical Service (EMS) from March, 2011 to May, 2014; 24cardiogenic-Heartsaver patients were enrolled in this study. They were divided into the myocardial infarction group (MIgroup) and the non-myocardial infarction group (Non-MIgroup) by final diagnosis for comparison of prehospital andin-hospital characteristics.
Results: The etiology of cardiac arrest cause of cardiogenic-Heartsaver was categorized according to five groups,including myocardial infarction (29.2%), Brugada syndrome(25.0%), idiopathic ventricular fibrillation (25.0%), idiopathicventricular tachycardia (8.3%), and coronary spasm(12.5%). Most patients had good neurological outcomes,Cerebral Performance Categories scale (CPC) median was1.0(1.0-1.0). The MI group showed higher average age(57.1¡¾6.49 vs 52.3¡¾13.0, p=0.036), high incidence of STsegmentelevation (42.9%), and nonspecific-ST or T-wavechange (24.9%) in electrocardiogram (ECG) after ROSC,higher incidence of regional wall motion abnormality inEchocardiography (85.7% vs 23.5%, p=0.009), and higherpeak level of CK-MB, troponin I within 12 hours (p=0.005,p=0.014). Some Non-MI patients had undergone an electrophysiologicstudy and received an implantable cardioverterdefibrillator.
Conclusion: Cardiogenic OHCA patients should be examinedby cardiac enzyme, ECG, echocardiography, andcoronary angiography in order to differentiate etiology. Besides, to prevent sudden cardiac death from fatalarrhythmia, electrophysiologic study and implantable cardioverterdefibrillator insertion therapy must be considered.
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Sudden cardiac death, Implantable cardioverter defibrillator, Out-of-Hospital cardiac arrest, Emergency medical service
KMID :
0385920140250060737
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To prevent sudden cardiac death from fatal arrhythmia, electrophysiologic study and implantable cardioverter defibrillator insertion therapy must be considered.