PREHOSPITAL CARDIAC ARREST SURVIVORS: CLASSIFICATION OF RISK GROUPS ON THE BASIS OF ELECTROPHYSIOLOGIC TESTING

This procedure may prove to be the most individualized and specific of the procedures currently available. Available data suggest that at least 30% of survivors of prehospital cardiac arrest can be managed best by this technique, and the numbers may ultimately prove to be higher. In those patients in whom the technique is not applicable, either because of lack of availability or controversial interpretation of information obtained, management should be guided by suppression of complex forms on ambulatory monitors and/or maintenance of stable therapeutic plasma levels of antiarrhythmic drugs. Our data suggest that the latter two might parallel each other quite well, because the plasma level targeted for an individual patient could be that which suppresses class IV-B and V ventricular arrhythmias. Once that level is achieved, its maintenance by careful dosage manipulation may be an adequate end point of therapy.