Causes and prognosis of cardiac arrest in a population admitted to a general hospital; a diagnostic and therapeutic problem
Identifieur interne : 003278 ( Main/Exploration ); précédent : 003277; suivant : 003279Causes and prognosis of cardiac arrest in a population admitted to a general hospital; a diagnostic and therapeutic problem
Auteurs : Béatrice Brembilla-Perrot [France] ; Hielko Miljoen [France] ; Pierre Houriez [France] ; Daniel Beurrier [France] ; Marc Nippert [France] ; Anne Claire Vancon [France] ; Arnaud Terrier De La Chaise [France] ; Pierre Louis [France] ; Laurent Mock [France] ; Nicolas Sadoul [France] ; Marius Andronache [France]Source :
- Resuscitation [ 0300-9572 ] ; 2003.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Adolescent, Adult, Aged, Aged, 80 and over, Arrhythmias, Cardiac (complications), Arrhythmias, Cardiac (therapy), Cardiocirculatory arrest, Cardiomyopathy, Dilated (complications), Cardiomyopathy, Dilated (therapy), Cardiopulmonary Resuscitation, Defibrillators, Implantable, Diagnosis, Electrophysiologic Techniques, Cardiac, Etiology, Female, Follow-Up Studies, Heart Arrest (etiology), Heart Arrest (therapy), Hospital, Human, Humans, Intensive cardiocirculatory care, Male, Middle Aged, Prognosis, Relapse, Risk factor, Survival Analysis, Treatment, Ventricular fibrillation.
- MESH :
- complications : Arrhythmias, Cardiac, Cardiomyopathy, Dilated.
- etiology : Heart Arrest.
- therapy : Arrhythmias, Cardiac, Cardiomyopathy, Dilated, Heart Arrest.
- Adolescent, Adult, Aged, Aged, 80 and over, Cardiopulmonary Resuscitation, Defibrillators, Implantable, Electrophysiologic Techniques, Cardiac, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Survival Analysis.
Abstract
Background: The purpose of this study was to determine the causes and the prognosis of consecutive patients resuscitated from cardiac arrest occurring in a general hospital. We assessed 28 females and 94 males (aged 13-82 years) who were resuscitated from cardiac arrest not attributable to acute myocardial infarction. Ventricular fibrillation (VF) was documented in 97. Non-cardiac causes were excluded. Non-invasive studies (24 h Holter monitoring, 2D echocardiogram, signal-averaged ECG, exercise testing, magnetic resonance imaging) and invasive studies (right and left ventricular angiography, coronary angiography and complete electrophysiologic study (EPS) were performed. Results: An underlying cardiac disease was found in 107 patients (88%). Patients were followed for a period ranging from 6 months to 10 years (mean 4±5 years). Several causes for cardiac arrest were identified and treated specifically. The prognosis was variable. Among surviving patients the following causes of cardiac arrest were found: Wolff-Parkinson-White syndrome (n = 2), rapid supraventricular tachycardia (n = 6), acquired or congenital long QT syndrome (n = 7), complete atrioventricular block (n = 3), proarrhythmic effect of an antiarrhythmic drug (n = 5), vasospastic angina (normal coronary arteries) (n = 5). Among ten patients with VF related to cardiac ischaemia two died suddenly. Ventricular tachycardia (VT) or VF was the main cause leading to resuscitation after cardiac arrest (n = 64). The risk of recurrence of arrest is confirmed in the present study particularly in patients in whom VT/VF could not be suppressed by antiarrhythmic drug therapy (n = 45) and in those where an ICD was not implanted (18 cardiac deaths (nine sudden cardiac deaths (SCD's)). The cause of cardiac arrest was not elucidated in 20 patients (16%). The prognosis of these patients differed according to the documentation of VF at the time of cardiac arrest: of those with documented VF (n = 12), six patients died suddenly (one with an ICD); of those without documented VF (n = 8), all are alive. Conclusion: To determine the precise cause of cardiac arrest was the first problem; the diagnosis of cardiac arrest clearly was erroneous in 8 of 122 patients (6.5%). In other patients, a ventricular tachyarrhythmia was identified as the cause for cardiac arrest in half of the population; the indication for an ICD is evident in this group. In 31% of patients with proven cardiac arrest, another arrhythmia requiring specific treatment was identified and ICD implantation was avoided; these patients had a survival of 92% at 3 years. In patients without an identified cause of cardiac arrest and negative EPS, the prognosis was unfavorable only in those with documented VF.
Affiliations:
Links toward previous steps (curation, corpus...)
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Le document en format XML
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<settlement type="city">Vandoeuvre les Nancy</settlement>
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<author><name sortKey="Terrier De La Chaise, Arnaud" sort="Terrier De La Chaise, Arnaud" uniqKey="Terrier De La Chaise A" first="Arnaud" last="Terrier De La Chaise">Arnaud Terrier De La Chaise</name>
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<s2>54500 Vandoeuvre les Nancy</s2>
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<author><name sortKey="Louis, Pierre" sort="Louis, Pierre" uniqKey="Louis P" first="Pierre" last="Louis">Pierre Louis</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Cardiology A, CHU of Brabois, Rue du Morvan</s1>
<s2>54500 Vandoeuvre les Nancy</s2>
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<placeName><region type="region" nuts="2">Grand Est</region>
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<settlement type="city">Vandoeuvre les Nancy</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mock, Laurent" sort="Mock, Laurent" uniqKey="Mock L" first="Laurent" last="Mock">Laurent Mock</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Cardiology A, CHU of Brabois, Rue du Morvan</s1>
<s2>54500 Vandoeuvre les Nancy</s2>
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<country>France</country>
<placeName><region type="region" nuts="2">Grand Est</region>
<region type="old region" nuts="2">Lorraine (région)</region>
<settlement type="city">Vandoeuvre les Nancy</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Sadoul, Nicolas" sort="Sadoul, Nicolas" uniqKey="Sadoul N" first="Nicolas" last="Sadoul">Nicolas Sadoul</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Cardiology A, CHU of Brabois, Rue du Morvan</s1>
<s2>54500 Vandoeuvre les Nancy</s2>
<s3>FRA</s3>
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<country>France</country>
<placeName><region type="region" nuts="2">Grand Est</region>
<region type="old region" nuts="2">Lorraine (région)</region>
<settlement type="city">Vandoeuvre les Nancy</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Andronache, Marius" sort="Andronache, Marius" uniqKey="Andronache M" first="Marius" last="Andronache">Marius Andronache</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Cardiology A, CHU of Brabois, Rue du Morvan</s1>
<s2>54500 Vandoeuvre les Nancy</s2>
<s3>FRA</s3>
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<country>France</country>
<placeName><region type="region" nuts="2">Grand Est</region>
<region type="old region" nuts="2">Lorraine (région)</region>
<settlement type="city">Vandoeuvre les Nancy</settlement>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">Resuscitation</title>
<title level="j" type="abbreviated">Resuscitation</title>
<idno type="ISSN">0300-9572</idno>
<imprint><date when="2003">2003</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">Resuscitation</title>
<title level="j" type="abbreviated">Resuscitation</title>
<idno type="ISSN">0300-9572</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term>
<term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Arrhythmias, Cardiac (complications)</term>
<term>Arrhythmias, Cardiac (therapy)</term>
<term>Cardiocirculatory arrest</term>
<term>Cardiomyopathy, Dilated (complications)</term>
<term>Cardiomyopathy, Dilated (therapy)</term>
<term>Cardiopulmonary Resuscitation</term>
<term>Defibrillators, Implantable</term>
<term>Diagnosis</term>
<term>Electrophysiologic Techniques, Cardiac</term>
<term>Etiology</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Heart Arrest (etiology)</term>
<term>Heart Arrest (therapy)</term>
<term>Hospital</term>
<term>Human</term>
<term>Humans</term>
<term>Intensive cardiocirculatory care</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Prognosis</term>
<term>Relapse</term>
<term>Risk factor</term>
<term>Survival Analysis</term>
<term>Treatment</term>
<term>Ventricular fibrillation</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Arrhythmias, Cardiac</term>
<term>Cardiomyopathy, Dilated</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Heart Arrest</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Arrhythmias, Cardiac</term>
<term>Cardiomyopathy, Dilated</term>
<term>Heart Arrest</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adolescent</term>
<term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Cardiopulmonary Resuscitation</term>
<term>Defibrillators, Implantable</term>
<term>Electrophysiologic Techniques, Cardiac</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Prognosis</term>
<term>Survival Analysis</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Arrêt cardiocirculatoire</term>
<term>Fibrillation ventriculaire</term>
<term>Etiologie</term>
<term>Diagnostic</term>
<term>Hôpital</term>
<term>Traitement</term>
<term>Pronostic</term>
<term>Facteur risque</term>
<term>Récidive</term>
<term>Réanimation cardiocirculatoire</term>
<term>Homme</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Background: The purpose of this study was to determine the causes and the prognosis of consecutive patients resuscitated from cardiac arrest occurring in a general hospital. We assessed 28 females and 94 males (aged 13-82 years) who were resuscitated from cardiac arrest not attributable to acute myocardial infarction. Ventricular fibrillation (VF) was documented in 97. Non-cardiac causes were excluded. Non-invasive studies (24 h Holter monitoring, 2D echocardiogram, signal-averaged ECG, exercise testing, magnetic resonance imaging) and invasive studies (right and left ventricular angiography, coronary angiography and complete electrophysiologic study (EPS) were performed. Results: An underlying cardiac disease was found in 107 patients (88%). Patients were followed for a period ranging from 6 months to 10 years (mean 4±5 years). Several causes for cardiac arrest were identified and treated specifically. The prognosis was variable. Among surviving patients the following causes of cardiac arrest were found: Wolff-Parkinson-White syndrome (n = 2), rapid supraventricular tachycardia (n = 6), acquired or congenital long QT syndrome (n = 7), complete atrioventricular block (n = 3), proarrhythmic effect of an antiarrhythmic drug (n = 5), vasospastic angina (normal coronary arteries) (n = 5). Among ten patients with VF related to cardiac ischaemia two died suddenly. Ventricular tachycardia (VT) or VF was the main cause leading to resuscitation after cardiac arrest (n = 64). The risk of recurrence of arrest is confirmed in the present study particularly in patients in whom VT/VF could not be suppressed by antiarrhythmic drug therapy (n = 45) and in those where an ICD was not implanted (18 cardiac deaths (nine sudden cardiac deaths (SCD's)). The cause of cardiac arrest was not elucidated in 20 patients (16%). The prognosis of these patients differed according to the documentation of VF at the time of cardiac arrest: of those with documented VF (n = 12), six patients died suddenly (one with an ICD); of those without documented VF (n = 8), all are alive. Conclusion: To determine the precise cause of cardiac arrest was the first problem; the diagnosis of cardiac arrest clearly was erroneous in 8 of 122 patients (6.5%). In other patients, a ventricular tachyarrhythmia was identified as the cause for cardiac arrest in half of the population; the indication for an ICD is evident in this group. In 31% of patients with proven cardiac arrest, another arrhythmia requiring specific treatment was identified and ICD implantation was avoided; these patients had a survival of 92% at 3 years. In patients without an identified cause of cardiac arrest and negative EPS, the prognosis was unfavorable only in those with documented VF.</div>
</front>
</TEI>
<affiliations><list><country><li>France</li>
</country>
<region><li>Grand Est</li>
<li>Lorraine (région)</li>
</region>
<settlement><li>Vandoeuvre les Nancy</li>
</settlement>
</list>
<tree><country name="France"><region name="Grand Est"><name sortKey="Brembilla Perrot, Beatrice" sort="Brembilla Perrot, Beatrice" uniqKey="Brembilla Perrot B" first="Béatrice" last="Brembilla-Perrot">Béatrice Brembilla-Perrot</name>
</region>
<name sortKey="Andronache, Marius" sort="Andronache, Marius" uniqKey="Andronache M" first="Marius" last="Andronache">Marius Andronache</name>
<name sortKey="Beurrier, Daniel" sort="Beurrier, Daniel" uniqKey="Beurrier D" first="Daniel" last="Beurrier">Daniel Beurrier</name>
<name sortKey="Houriez, Pierre" sort="Houriez, Pierre" uniqKey="Houriez P" first="Pierre" last="Houriez">Pierre Houriez</name>
<name sortKey="Louis, Pierre" sort="Louis, Pierre" uniqKey="Louis P" first="Pierre" last="Louis">Pierre Louis</name>
<name sortKey="Miljoen, Hielko" sort="Miljoen, Hielko" uniqKey="Miljoen H" first="Hielko" last="Miljoen">Hielko Miljoen</name>
<name sortKey="Mock, Laurent" sort="Mock, Laurent" uniqKey="Mock L" first="Laurent" last="Mock">Laurent Mock</name>
<name sortKey="Nippert, Marc" sort="Nippert, Marc" uniqKey="Nippert M" first="Marc" last="Nippert">Marc Nippert</name>
<name sortKey="Sadoul, Nicolas" sort="Sadoul, Nicolas" uniqKey="Sadoul N" first="Nicolas" last="Sadoul">Nicolas Sadoul</name>
<name sortKey="Terrier De La Chaise, Arnaud" sort="Terrier De La Chaise, Arnaud" uniqKey="Terrier De La Chaise A" first="Arnaud" last="Terrier De La Chaise">Arnaud Terrier De La Chaise</name>
<name sortKey="Vancon, Anne Claire" sort="Vancon, Anne Claire" uniqKey="Vancon A" first="Anne Claire" last="Vancon">Anne Claire Vancon</name>
</country>
</tree>
</affiliations>
</record>
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