Outcome of resuscitation from bradyarrhythmic or asystolic prehospital cardiac arrest

Robert J Myerburg, D. Estes, L. Zaman, R. M. Luceri, K. M. Kessler, R. G. Trohman, Agustin Castellanos

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Previous studies of outcome as a function of the initial electrophysiologic mechanisms recorded at the scene of prehospital cardiac arrest have demonstrated that bradyarrhythmias and asystole have the worst prognosis. In this report, our observations in bradyarrhythmic and asystolic arrests occurring from 1980 to 1982 are compared with those from 1975 to 1978. From 1980 to 1982, 61 (27%) of 225 cardiac arrest events meeting entry criteria for the study were bradyarrhythmic or asystolic. Only 2 (8%) of 24 patients with asystole and 1 (20%) of 5 patients with sinus bradycardia survived prehospital intervention. Only 1 of these 29 patients were discharged from the hospital alive. In contrast, 15 (47%) of 32 patients who presented with idioventricular rhythm at initial contact survived prehospital intervention and were hospitalized, and 8 (25%) of these 32 were ultimately discharged alive. When compared with the 1975 to 1978 patients with bradyarrhythmia and asystole, both prehospital survival (8 versus 30%, p < 0.001) and survival after hospitalization (0 versus 15%, p < 0.05) significantly improved, but the improvement occurred predominantly in the subgroup with idioventricular rhythm. Survivors within this subgroup tended to have a prompt response to prehospital pharmacologic interventions that were not available to the 1975 to 1978 group. The response was manifested by return to a sinus mechanism or increase in the rate of idioventricular rhythm. In conclusion, outcome has improved for a specific subgroup of victims of prehospital cardiac arrest with bradyarrhythmia or asystole; the improved outcome may relate to field interventions by rescue personnel at the scene of arrest but the mortality rate is still high.

Original languageEnglish
Pages (from-to)1118-1122
Number of pages5
JournalJournal of the American College of Cardiology
Volume4
Issue number6
DOIs
StatePublished - Dec 1 1984
Externally publishedYes

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Heart Arrest
Resuscitation
Bradycardia
Survival
Survivors
Hospitalization
Outcome Assessment (Health Care)
Mortality

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Outcome of resuscitation from bradyarrhythmic or asystolic prehospital cardiac arrest. / Myerburg, Robert J; Estes, D.; Zaman, L.; Luceri, R. M.; Kessler, K. M.; Trohman, R. G.; Castellanos, Agustin.

In: Journal of the American College of Cardiology, Vol. 4, No. 6, 01.12.1984, p. 1118-1122.

Research output: Contribution to journalArticle

Myerburg, Robert J ; Estes, D. ; Zaman, L. ; Luceri, R. M. ; Kessler, K. M. ; Trohman, R. G. ; Castellanos, Agustin. / Outcome of resuscitation from bradyarrhythmic or asystolic prehospital cardiac arrest. In: Journal of the American College of Cardiology. 1984 ; Vol. 4, No. 6. pp. 1118-1122.
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