Procainamide and survival in ventricular fibrillation out-of-hospital cardiac arrest

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
David T MarkelP J Kudenchuk

Abstract

Procainamide is an antiarrhythmic drug of unproven efficacy in cardiac arrest. The association between procainamide and survival from out-of-hospital cardiac arrest was investigated to better determine the drug's potential role in resuscitation. The authors conducted a 10-year study of all witnessed, out-of-hospital, ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) cardiac arrests treated by emergency medical services (EMS) in King County, Washington. Patients were considered eligible for procainamide if they received more than three defibrillation shocks and intravenous (IV) bolus lidocaine. Four logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CI) describing the relationship between procainamide and survival. Of the 665 eligible patients, 176 received procainamide, and 489 did not. On average, procainamide recipients received more shocks and pharmacologic interventions and had lengthier resuscitations. Adjusted for their clinical and resuscitation characteristics, procainamide recipients had a lower likelihood of survival to hospital discharge (OR = 0.52; 95% CI = 0.36 to 0.75). Further adjustment for receipt of other cardiac medications during resuscitat...Continue Reading

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Citations

Jun 5, 2012·Circulation. Cardiovascular Genetics·Catherine O JohnsonThomas D Rea
Jul 14, 2014·The Veterinary Clinics of North America. Equine Practice·Jonna Maaria Jokisalo, Kevin Thomas Trent Corley
Aug 18, 2016·European Heart Journal. Cardiovascular Pharmacotherapy·Andreas LundinPeter Lundgren
Jan 11, 2012·Resuscitation·Thomas D Rea, Florence Dumas
Aug 3, 2012·Journal of Veterinary Emergency and Critical Care·Elizabeth A RozanskiUNKNOWN RECOVER Advanced Life Support Domain Worksheet Authors
Apr 19, 2011·Current Opinion in Critical Care·Peter T Morley

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