Implantable cardioverter-defibrillators have reduced the incidence of resuscitation for out-of-hospital cardiac...

Area of Science:

• Cardiology
• Public Health
• Emergency Medicine

Background:

• A notable decrease in ventricular fibrillation (VF) as the initial rhythm during out-of-hospital cardiac arrest (OHCA) resuscitation has been observed.
• The study aimed to determine the specific impact of implantable cardioverter-defibrillator (ICD) therapy on this observed decline.

Purpose of the Study:

• To quantify the contribution of ICD therapy to the reduction in VF OHCA incidence.
• To compare VF OHCA rates over two distinct periods (1995-1997 and 2005-2008).

Main Methods:

• Utilized a prospective database (Amsterdam Resuscitation Studies [ARREST]) for OHCA resuscitation data in North Holland (2005-2008).
• Compared current VF OHCA incidence with historical data (1995-1997).
• Analyzed ICD interrogations to identify appropriate shocks and estimate prevented VF OHCA episodes.

Main Results:

• VF OHCA incidence decreased from 21.1 to 17.4 per 100,000 inhabitants annually (P<0.001).
• Non-VF OHCA incidence increased from 12.2 to 19.4 per 100,000 inhabitants annually (P<0.001).
• An estimated 81 VF OHCA cases were prevented by 339 appropriate ICD shocks, accounting for 33% of the observed decline.

Conclusions:

• ICD therapy significantly contributed to the decrease in VF OHCA incidence in North Holland.
• ICD therapy accounted for an annual reduction of 1.2 per 100,000 inhabitants, representing 33% of the overall decline in VF OHCA.