Different defibrillation strategies in survivors after out-of-hospital cardiac arrest

Jolande A. Zijlstra; Rudolph W. Koster; Marieke T. Blom; Freddy K. Lippert; Leif Svensson; Johan Herlitz; Jo Kramer-Johansen; Mattias Ringh; Mårten Rosenqvist; Thea Palsgaard Møller; Hanno L. Tan; Stefanie G. Beesems; Michiel Hulleman; Andreas Claesson; Fredrik Folke; Theresa Mariero Olasveengen; Mads Wissenberg; Carolina Malta Hansen; Soren Viereck; Jacob Hollenberg

doi:10.1136/heartjnl-2017-312622

Different defibrillation strategies in survivors after out-of-hospital cardiac arrest

Jolande A. Zijlstra, Rudolph W. Koster, Marieke T. Blom, Freddy K. Lippert, Leif Svensson, Johan Herlitz, Jo Kramer-Johansen, Mattias Ringh, Mårten Rosenqvist, Thea Palsgaard Møller, Hanno L. Tan, Stefanie G. Beesems, Michiel Hulleman, Andreas Claesson, Fredrik Folke, Theresa Mariero Olasveengen, Mads Wissenberg, Carolina Malta Hansen, Soren Viereck, Jacob Hollenberg^*

^*Corresponding author for this work

Department of Clinical Medicine

10 Citations (Scopus)

Abstract

AbsTrACT background in the last decade, there has been a rapid increase in the dissemination of automated external defibrillators (aeDs) for prehospital defibrillation of out-of-hospital cardiac arrest patients. the aim of this study was to study the association between different defibrillation strategies on survival rates over time in copenhagen, stockholm, Western Sweden and Amsterdam, and the hypothesis was that non-eMs defibrillation increased over time and was associated with increased survival. Methods We performed a retrospective analysis of four prospectively collected cohorts of out-of-hospital cardiac arrest patients between 2008 and 2013. emergency medical service (eMs)-witnessed arrests were excluded. results a total of 22 453 out-of-hospital cardiac arrest patients with known survival status were identified, of whom 2957 (13%) survived at least 30 days postresuscitation. Of all survivors with a known defibrillation status, 2289 (81%) were defibrillated, 1349 (59%) were defibrillated by eMs, 454 (20%) were defibrillated by a first responder aeD and 429 (19%) were defibrillated by an onsite aeD and 57 (2%) were unknown. the percentage of survivors defibrillated by first responder aeDs (from 13% in 2008 to 26% in 2013, p<0.001 for trend) and onsite aeDs (from 14% in 2008 to 30% in 2013, p<0.001 for trend) increased. the increased use of these non-eMs aeDs was associated with the increase in survival rate of patients with a shockable initial rhythm. Conclusion survivors of out-of-hospital cardiac arrest are increasingly defibrillated by non-eMs aeDs. this increase is primarily due to a large increase in the use of onsite aeDs as well as an increase in first-responder defibrillation over time. non-eMs defibrillation accounted for at least part of the increase in survival rate of patients with a shockable initial rhythm.

Original language	English
Journal	Heart
Volume	104
Issue number	23
Pages (from-to)	1929-1936
Number of pages	8
ISSN	1355-6037
DOIs	https://doi.org/10.1136/heartjnl-2017-312622
Publication status	Published - 2018

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10.1136/heartjnl-2017-312622

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Zijlstra, J. A., Koster, R. W., Blom, M. T., Lippert, F. K., Svensson, L., Herlitz, J., Kramer-Johansen, J., Ringh, M., Rosenqvist, M., Møller, T. P., Tan, H. L., Beesems, S. G., Hulleman, M., Claesson, A., Folke, F., Olasveengen, T. M., Wissenberg, M., Hansen, C. M., Viereck, S., & Hollenberg, J. (2018). Different defibrillation strategies in survivors after out-of-hospital cardiac arrest. Heart, 104(23), 1929-1936. https://doi.org/10.1136/heartjnl-2017-312622

Zijlstra, JA, Koster, RW, Blom, MT, Lippert, FK, Svensson, L, Herlitz, J, Kramer-Johansen, J, Ringh, M, Rosenqvist, M, Møller, TP, Tan, HL, Beesems, SG, Hulleman, M, Claesson, A, Folke, F, Olasveengen, TM, Wissenberg, M, Hansen, CM, Viereck, S & Hollenberg, J 2018, 'Different defibrillation strategies in survivors after out-of-hospital cardiac arrest', Heart, vol. 104, no. 23, pp. 1929-1936. https://doi.org/10.1136/heartjnl-2017-312622

@article{d02beb823b244b8db0404efca4575214,

title = "Different defibrillation strategies in survivors after out-of-hospital cardiac arrest",

abstract = "AbsTrACT background in the last decade, there has been a rapid increase in the dissemination of automated external defibrillators (aeDs) for prehospital defibrillation of out-of-hospital cardiac arrest patients. the aim of this study was to study the association between different defibrillation strategies on survival rates over time in copenhagen, stockholm, Western Sweden and Amsterdam, and the hypothesis was that non-eMs defibrillation increased over time and was associated with increased survival. Methods We performed a retrospective analysis of four prospectively collected cohorts of out-of-hospital cardiac arrest patients between 2008 and 2013. emergency medical service (eMs)-witnessed arrests were excluded. results a total of 22 453 out-of-hospital cardiac arrest patients with known survival status were identified, of whom 2957 (13%) survived at least 30 days postresuscitation. Of all survivors with a known defibrillation status, 2289 (81%) were defibrillated, 1349 (59%) were defibrillated by eMs, 454 (20%) were defibrillated by a first responder aeD and 429 (19%) were defibrillated by an onsite aeD and 57 (2%) were unknown. the percentage of survivors defibrillated by first responder aeDs (from 13% in 2008 to 26% in 2013, p<0.001 for trend) and onsite aeDs (from 14% in 2008 to 30% in 2013, p<0.001 for trend) increased. the increased use of these non-eMs aeDs was associated with the increase in survival rate of patients with a shockable initial rhythm. Conclusion survivors of out-of-hospital cardiac arrest are increasingly defibrillated by non-eMs aeDs. this increase is primarily due to a large increase in the use of onsite aeDs as well as an increase in first-responder defibrillation over time. non-eMs defibrillation accounted for at least part of the increase in survival rate of patients with a shockable initial rhythm.",

author = "Zijlstra, {Jolande A.} and Koster, {Rudolph W.} and Blom, {Marieke T.} and Lippert, {Freddy K.} and Leif Svensson and Johan Herlitz and Jo Kramer-Johansen and Mattias Ringh and M{\aa}rten Rosenqvist and M{\o}ller, {Thea Palsgaard} and Tan, {Hanno L.} and Beesems, {Stefanie G.} and Michiel Hulleman and Andreas Claesson and Fredrik Folke and Olasveengen, {Theresa Mariero} and Mads Wissenberg and Hansen, {Carolina Malta} and Soren Viereck and Jacob Hollenberg",

year = "2018",

doi = "10.1136/heartjnl-2017-312622",

language = "English",

volume = "104",

pages = "1929--1936",

journal = "Heart",

issn = "1355-6037",

publisher = "B M J Group",

number = "23",

}

TY - JOUR

T1 - Different defibrillation strategies in survivors after out-of-hospital cardiac arrest

AU - Zijlstra, Jolande A.

AU - Koster, Rudolph W.

AU - Blom, Marieke T.

AU - Lippert, Freddy K.

AU - Svensson, Leif

AU - Herlitz, Johan

AU - Kramer-Johansen, Jo

AU - Ringh, Mattias

AU - Rosenqvist, Mårten

AU - Møller, Thea Palsgaard

AU - Tan, Hanno L.

AU - Beesems, Stefanie G.

AU - Hulleman, Michiel

AU - Claesson, Andreas

AU - Folke, Fredrik

AU - Olasveengen, Theresa Mariero

AU - Wissenberg, Mads

AU - Hansen, Carolina Malta

AU - Viereck, Soren

AU - Hollenberg, Jacob

PY - 2018

Y1 - 2018

N2 - AbsTrACT background in the last decade, there has been a rapid increase in the dissemination of automated external defibrillators (aeDs) for prehospital defibrillation of out-of-hospital cardiac arrest patients. the aim of this study was to study the association between different defibrillation strategies on survival rates over time in copenhagen, stockholm, Western Sweden and Amsterdam, and the hypothesis was that non-eMs defibrillation increased over time and was associated with increased survival. Methods We performed a retrospective analysis of four prospectively collected cohorts of out-of-hospital cardiac arrest patients between 2008 and 2013. emergency medical service (eMs)-witnessed arrests were excluded. results a total of 22 453 out-of-hospital cardiac arrest patients with known survival status were identified, of whom 2957 (13%) survived at least 30 days postresuscitation. Of all survivors with a known defibrillation status, 2289 (81%) were defibrillated, 1349 (59%) were defibrillated by eMs, 454 (20%) were defibrillated by a first responder aeD and 429 (19%) were defibrillated by an onsite aeD and 57 (2%) were unknown. the percentage of survivors defibrillated by first responder aeDs (from 13% in 2008 to 26% in 2013, p<0.001 for trend) and onsite aeDs (from 14% in 2008 to 30% in 2013, p<0.001 for trend) increased. the increased use of these non-eMs aeDs was associated with the increase in survival rate of patients with a shockable initial rhythm. Conclusion survivors of out-of-hospital cardiac arrest are increasingly defibrillated by non-eMs aeDs. this increase is primarily due to a large increase in the use of onsite aeDs as well as an increase in first-responder defibrillation over time. non-eMs defibrillation accounted for at least part of the increase in survival rate of patients with a shockable initial rhythm.

AB - AbsTrACT background in the last decade, there has been a rapid increase in the dissemination of automated external defibrillators (aeDs) for prehospital defibrillation of out-of-hospital cardiac arrest patients. the aim of this study was to study the association between different defibrillation strategies on survival rates over time in copenhagen, stockholm, Western Sweden and Amsterdam, and the hypothesis was that non-eMs defibrillation increased over time and was associated with increased survival. Methods We performed a retrospective analysis of four prospectively collected cohorts of out-of-hospital cardiac arrest patients between 2008 and 2013. emergency medical service (eMs)-witnessed arrests were excluded. results a total of 22 453 out-of-hospital cardiac arrest patients with known survival status were identified, of whom 2957 (13%) survived at least 30 days postresuscitation. Of all survivors with a known defibrillation status, 2289 (81%) were defibrillated, 1349 (59%) were defibrillated by eMs, 454 (20%) were defibrillated by a first responder aeD and 429 (19%) were defibrillated by an onsite aeD and 57 (2%) were unknown. the percentage of survivors defibrillated by first responder aeDs (from 13% in 2008 to 26% in 2013, p<0.001 for trend) and onsite aeDs (from 14% in 2008 to 30% in 2013, p<0.001 for trend) increased. the increased use of these non-eMs aeDs was associated with the increase in survival rate of patients with a shockable initial rhythm. Conclusion survivors of out-of-hospital cardiac arrest are increasingly defibrillated by non-eMs aeDs. this increase is primarily due to a large increase in the use of onsite aeDs as well as an increase in first-responder defibrillation over time. non-eMs defibrillation accounted for at least part of the increase in survival rate of patients with a shockable initial rhythm.

U2 - 10.1136/heartjnl-2017-312622

DO - 10.1136/heartjnl-2017-312622

M3 - Journal article

C2 - 29903805

AN - SCOPUS:85056620114

SN - 1355-6037

VL - 104

SP - 1929

EP - 1936

JO - Heart

JF - Heart

IS - 23

ER -

Different defibrillation strategies in survivors after out-of-hospital cardiac arrest

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