Analysis of amplitude spectral area and slope to predict defibrillation in out of hospital cardiac arrest due to ventricular fibrillation (VF) according to VF type: recurrent versus shock-resistant

Resuscitation
Madhan ShanmugasundaramJulia H Indik

Abstract

In out-of-hospital cardiac arrest (OHCA) due to ventricular fibrillation (VF), VF may recur during resuscitation (recurrent VF) or fail to defibrillate (shock-resistant VF). While retrospective studies have suggested that amplitude spectral area (AMSA) and slope predict defibrillation, it is unknown whether the predictive power is influenced by VF type. We hypothesized that in witnessed OHCA with initial rhythm of VF that the utility for AMSA and slope to predict defibrillation would differ between shock-resistant and recurrent VF. AMSA and slope were measured immediately prior to each shock. For second or later shocks, VF was classified as recurrent or shock-resistant. Cardiac arrest was classified according to whether the majority of shocks were for recurrent VF or shock-resistant VF. 44 patients received 98 shocks for recurrent VF and 96 shocks for shock-resistant VF; 24 patients achieved ROSC in the field. AMSA and slope were higher in recurrent VF compared to shock-resistant VF (AMSA: 28.8±13.1 vs 15.2±8.6 mVHz, P<0.001, and slope: 2.9±1.4 vs 1.4±1.0 mVs(-1), P=0.001). Recurrent VF was more likely to defibrillate than shock-resistant VF (P<0.001). AMSA and slope predicted defibrillation in shock-resistant VF (P<0.001 for b...Continue Reading

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Citations

Dec 10, 2014·The Journal of Emergency Medicine·Meghan McGovernJulia H Indik
Apr 1, 2016·Current Opinion in Critical Care·Roberta AffatatoGiuseppe Ristagno
Dec 4, 2014·Circulation·Giuseppe RistagnoUNKNOWN Azienda Regionale Emergenza Urgenza Research Group
Dec 20, 2017·Sudebno-meditsinskaia ekspertiza·G I AvkhodievO A Turanov
Jun 8, 2021·Journal of the American Heart Association·Tia T RaymondUNKNOWN Pediatric Resuscitation Quality Collaborative (pediRES‐Q) Investigators
Jul 13, 2020·Resuscitation·Daniel JostUNKNOWN Paris Fire Brigade Cardiac Arrest Task Force investigators

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