Related Experiment Video

Updated: May 5, 2026

Pre-clinical Model of Cardiac Donation after Circulatory Death
06:26

Pre-clinical Model of Cardiac Donation after Circulatory Death

Published on: August 2, 2019

7.8K

Association Between No-Flow Time, Prehospital Low-Flow Time, and Conversion to Nonshockable Rhythm in Patients With

Kenji Kandori1,2, Satoshi Nakajima3, Tasuku Matsuyama3

  • 1Department of Emergency and Critical Care Medicine, Japanese Red Cross Society Kyoto Daini Hospital Kyoto Japan.

Journal of the American Heart Association
|February 26, 2025
PubMed

Insights

Prolonged no-flow time (NFT) and prehospital low-flow time (LFT) in out-of-hospital cardiac arrest (OHCA) patients with an initial shockable rhythm increase the likelihood of conversion to a nonshockable rhythm upon hospital arrival.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Resuscitation Science

Background:

  • Out-of-hospital cardiac arrest (OHCA) with initial shockable rhythm typically has a better prognosis.
  • Prognosis significantly declines if the initial shockable rhythm converts to a nonshockable rhythm by hospital arrival.
  • Understanding factors influencing this rhythm conversion is crucial for improving patient outcomes.

Purpose of the Study:

  • To investigate the association between no-flow time (NFT) and prehospital low-flow time (LFT).
  • To determine the impact of NFT and LFT on the conversion to a nonshockable rhythm in OHCA patients with initial shockable rhythm.
  • To provide insights into the temporal dynamics of cardiac arrest rhythms during prehospital and early hospital phases.

Main Methods:

  • Analysis of adult OHCA patients with initial shockable rhythm from the JAAM-OHCA registry (June 2014-December 2020).
  • Primary outcome: rhythm conversion to nonshockable rhythm on hospital arrival.
  • Logistic regression models were used to calculate adjusted odds ratios (aORs) for NFT and LFT associations with rhythm conversion.

Main Results:

  • In a cohort of 3720 patients, 39.3% converted to a nonshockable rhythm by hospital arrival.
  • Longer NFT was significantly associated with increased odds of rhythm conversion (e.g., ≥10 minutes: aOR, 1.75).
  • Extended prehospital LFT demonstrated a strong dose-response association with rhythm conversion (e.g., ≥30 minutes: aOR, 6.85).

Conclusions:

  • Prolonged no-flow time (NFT) is a significant predictor of rhythm conversion to nonshockable in OHCA patients.
  • Extended prehospital low-flow time (LFT) is also strongly associated with this unfavorable rhythm transition.
  • These findings highlight the critical importance of minimizing both NFT and LFT to improve outcomes for OHCA patients with initial shockable rhythms.
Abstract

Keywords:
ECPRprognosisresuscitationrhythm conversionventricular fibrillation

More Related Videos

Standardized Model of Ventricular Fibrillation and Advanced Cardiac Life Support in Swine05:36

Standardized Model of Ventricular Fibrillation and Advanced Cardiac Life Support in Swine

Published on: January 30, 2020

7.6K
Transthoracic Echocardiography to Assess Post-Resuscitation Left Ventricular Dysfunction After Acute Myocardial Infarction and Cardiac Arrest in Pigs08:19

Transthoracic Echocardiography to Assess Post-Resuscitation Left Ventricular Dysfunction After Acute Myocardial Infarction and Cardiac Arrest in Pigs

Published on: July 12, 2022

2.7K

Related Concept Videos

Pulse rhythm01:30

Pulse rhythm

Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
1.7K
Cardiopulmonary Resuscitation I: Adult01:21

Cardiopulmonary Resuscitation I: Adult

Cardiopulmonary resuscitation, or CPR, is a life-saving emergency procedure performed when a person's heart has stopped beating or they are no longer breathing. The foundation of CPR is Basic Life Support (BLS), which focuses on the early recognition of cardiac arrest, the immediate start of high-quality chest compressions, and the timely use of an automated external defibrillator (AED).Assessing Responsiveness and Checking the Carotid PulseWhen approaching an unresponsive person, first ensure...
1.3K
Cardiopulmonary Resuscitation III: AED Use01:23

Cardiopulmonary Resuscitation III: AED Use

Introduction to AEDAn Automated External Defibrillator (AED) is a portable medical device that analyzes the heart's rhythm and, if necessary, delivers an electrical shock to help the heart re-establish an effective rhythm during sudden cardiac arrest (SCA). SCA occurs when the heart suddenly and unexpectedly stops beating, leading to a loss of blood flow to the brain and other vital organs. In such emergencies, time is of the essence, and using an AED, combined with Cardiopulmonary...
1.7K
Cardiopulmonary Resuscitation IV: Pharmacological Management01:25

Cardiopulmonary Resuscitation IV: Pharmacological Management

Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
1.7K