Causes and prognosis of cardiac arrest in a population admitted to a general hospital; a diagnostic and therapeutic problem
Identifieur interne : 000E64 ( PascalFrancis/Corpus ); précédent : 000E63; suivant : 000E65Causes and prognosis of cardiac arrest in a population admitted to a general hospital; a diagnostic and therapeutic problem
Auteurs : Béatrice Brembilla-Perrot ; Hielko Miljoen ; Pierre Houriez ; Daniel Beurrier ; Marc Nippert ; Anne Claire Vancon ; Arnaud Terrier De La Chaise ; Pierre Louis ; Laurent Mock ; Nicolas Sadoul ; Marius AndronacheSource :
- Resuscitation [ 0300-9572 ] ; 2003.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
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.
Notice en format standard (ISO 2709)
Pour connaître la documentation sur le format Inist Standard.
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Format Inist (serveur)
NO : | PASCAL 04-0078841 INIST |
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ET : | Causes and prognosis of cardiac arrest in a population admitted to a general hospital; a diagnostic and therapeutic problem |
AU : | BREMBILLA-PERROT (Béatrice); MILJOEN (Hielko); HOURIEZ (Pierre); BEURRIER (Daniel); NIPPERT (Marc); VANCON (Anne Claire); TERRIER DE LA CHAISE (Arnaud); LOUIS (Pierre); MOCK (Laurent); SADOUL (Nicolas); ANDRONACHE (Marius); CHAMBERLAIN (Douglas); HANDLEY (Anthony J.); COLQUHOUN (Michael) |
AF : | Cardiology A, CHU of Brabois, Rue du Morvan/54500 Vandoeuvre les Nancy/France (1 aut., 2 aut., 3 aut., 4 aut., 5 aut., 6 aut., 7 aut., 8 aut., 9 aut., 10 aut., 11 aut.); The Sir Geraint Evans Wales Heart Research Institute, The University of College of Medicine, Heath Park/Cardiff, DF14 4XN/Royaume-Uni (1 aut., 3 aut.); Prehospital Research Unit, Landsdowne Hospital, Sanatorium Roa d, Canton/Cardiff, CF1 8UL/Royaume-Uni (1 aut., 2 aut.); Resuscitation Council (UK), Fifth Floor, Tavistock House North, Tavistock Square/London, WC1H 9JP/Royaume-Uni (3 aut.) |
DT : | Publication en série; Niveau analytique |
SO : | Resuscitation; ISSN 0300-9572; Coden RSUSBS; Irlande; Da. 2003; Vol. 58; No. 3; Pp. 319-327; Abs. portugais/espagnol; Bibl. 33 ref. |
LA : | Anglais |
EA : | 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. |
CC : | 002B27B01 |
FD : | Arrêt cardiocirculatoire; Fibrillation ventriculaire; Etiologie; Diagnostic; Hôpital; Traitement; Pronostic; Facteur risque; Récidive; Réanimation cardiocirculatoire; Homme |
FG : | Appareil circulatoire pathologie; Cardiopathie; Trouble rythme cardiaque; Trouble excitabilité |
ED : | Cardiocirculatory arrest; Ventricular fibrillation; Etiology; Diagnosis; Hospital; Treatment; Prognosis; Risk factor; Relapse; Intensive cardiocirculatory care; Human |
EG : | Cardiovascular disease; Heart disease; Arrhythmia; Excitability disorder |
SD : | Paro cardiocirculatorio; Fibrilación ventricular; Etiología; Diagnóstico; Hospital; Tratamiento; Pronóstico; Factor riesgo; Recaida; Reanimación cardiocirculatoria; Hombre |
LO : | INIST-21284.354000112968040130 |
ID : | 04-0078841 |
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<author><name sortKey="Andronache, Marius" sort="Andronache, Marius" uniqKey="Andronache M" first="Marius" last="Andronache">Marius Andronache</name>
<affiliation><inist:fA14 i1="01"><s1>Cardiology A, CHU of Brabois, Rue du Morvan</s1>
<s2>54500 Vandoeuvre les Nancy</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>6 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>8 aut.</sZ>
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<series><title level="j" type="main">Resuscitation</title>
<title level="j" type="abbreviated">Resuscitation</title>
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<imprint><date when="2003">2003</date>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Cardiocirculatory arrest</term>
<term>Diagnosis</term>
<term>Etiology</term>
<term>Hospital</term>
<term>Human</term>
<term>Intensive cardiocirculatory care</term>
<term>Prognosis</term>
<term>Relapse</term>
<term>Risk factor</term>
<term>Treatment</term>
<term>Ventricular fibrillation</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>
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<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>
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<fA08 i1="01" i2="1" l="ENG"><s1>Causes and prognosis of cardiac arrest in a population admitted to a general hospital; a diagnostic and therapeutic problem</s1>
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<fA11 i1="01" i2="1"><s1>BREMBILLA-PERROT (Béatrice)</s1>
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<fA11 i1="02" i2="1"><s1>MILJOEN (Hielko)</s1>
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<fA11 i1="03" i2="1"><s1>HOURIEZ (Pierre)</s1>
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<fA11 i1="04" i2="1"><s1>BEURRIER (Daniel)</s1>
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<fA11 i1="05" i2="1"><s1>NIPPERT (Marc)</s1>
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<fA11 i1="06" i2="1"><s1>VANCON (Anne Claire)</s1>
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<fA11 i1="07" i2="1"><s1>TERRIER DE LA CHAISE (Arnaud)</s1>
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<fA11 i1="08" i2="1"><s1>LOUIS (Pierre)</s1>
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<fA11 i1="09" i2="1"><s1>MOCK (Laurent)</s1>
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<fA11 i1="10" i2="1"><s1>SADOUL (Nicolas)</s1>
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<fA11 i1="11" i2="1"><s1>ANDRONACHE (Marius)</s1>
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<fA12 i1="01" i2="1"><s1>CHAMBERLAIN (Douglas)</s1>
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<fA12 i1="02" i2="1"><s1>HANDLEY (Anthony J.)</s1>
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<fA12 i1="03" i2="1"><s1>COLQUHOUN (Michael)</s1>
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<fA14 i1="01"><s1>Cardiology A, CHU of Brabois, Rue du Morvan</s1>
<s2>54500 Vandoeuvre les Nancy</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
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<fA15 i1="01"><s1>The Sir Geraint Evans Wales Heart Research Institute, The University of College of Medicine, Heath Park</s1>
<s2>Cardiff, DF14 4XN</s2>
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<sZ>1 aut.</sZ>
<sZ>3 aut.</sZ>
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<fA15 i1="02"><s1>Prehospital Research Unit, Landsdowne Hospital, Sanatorium Roa d, Canton</s1>
<s2>Cardiff, CF1 8UL</s2>
<s3>GBR</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
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<fA15 i1="03"><s1>Resuscitation Council (UK), Fifth Floor, Tavistock House North, Tavistock Square</s1>
<s2>London, WC1H 9JP</s2>
<s3>GBR</s3>
<sZ>3 aut.</sZ>
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<server><NO>PASCAL 04-0078841 INIST</NO>
<ET>Causes and prognosis of cardiac arrest in a population admitted to a general hospital; a diagnostic and therapeutic problem</ET>
<AU>BREMBILLA-PERROT (Béatrice); MILJOEN (Hielko); HOURIEZ (Pierre); BEURRIER (Daniel); NIPPERT (Marc); VANCON (Anne Claire); TERRIER DE LA CHAISE (Arnaud); LOUIS (Pierre); MOCK (Laurent); SADOUL (Nicolas); ANDRONACHE (Marius); CHAMBERLAIN (Douglas); HANDLEY (Anthony J.); COLQUHOUN (Michael)</AU>
<AF>Cardiology A, CHU of Brabois, Rue du Morvan/54500 Vandoeuvre les Nancy/France (1 aut., 2 aut., 3 aut., 4 aut., 5 aut., 6 aut., 7 aut., 8 aut., 9 aut., 10 aut., 11 aut.); The Sir Geraint Evans Wales Heart Research Institute, The University of College of Medicine, Heath Park/Cardiff, DF14 4XN/Royaume-Uni (1 aut., 3 aut.); Prehospital Research Unit, Landsdowne Hospital, Sanatorium Roa d, Canton/Cardiff, CF1 8UL/Royaume-Uni (1 aut., 2 aut.); Resuscitation Council (UK), Fifth Floor, Tavistock House North, Tavistock Square/London, WC1H 9JP/Royaume-Uni (3 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>Resuscitation; ISSN 0300-9572; Coden RSUSBS; Irlande; Da. 2003; Vol. 58; No. 3; Pp. 319-327; Abs. portugais/espagnol; Bibl. 33 ref.</SO>
<LA>Anglais</LA>
<EA>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.</EA>
<CC>002B27B01</CC>
<FD>Arrêt cardiocirculatoire; Fibrillation ventriculaire; Etiologie; Diagnostic; Hôpital; Traitement; Pronostic; Facteur risque; Récidive; Réanimation cardiocirculatoire; Homme</FD>
<FG>Appareil circulatoire pathologie; Cardiopathie; Trouble rythme cardiaque; Trouble excitabilité</FG>
<ED>Cardiocirculatory arrest; Ventricular fibrillation; Etiology; Diagnosis; Hospital; Treatment; Prognosis; Risk factor; Relapse; Intensive cardiocirculatory care; Human</ED>
<EG>Cardiovascular disease; Heart disease; Arrhythmia; Excitability disorder</EG>
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