Effect of Implantable Cardioverter-defibrillator Therapy for Ventricular Fibrillation Patients with Out-of-hospital Cardiac Arrest

Abstract

Survivors of ventricular fibrillation out-of-hospital cardiac arrest(VFOHCA)due to potentially reversible causes such as acute coronary syndrome(ACS), vasospastic angina and electrolyte abnormalities are considered low risk for recurrent arrhythmia. Accordingly, implantable cardioverter-de brillator therapy is not routinely recommended in such patients. We investigated the risk of mortality and the value of ICD therapy for VF-OHCA. Among 2,248 cardiopulmonary arrest patients presenting at our hospital, we retrospectively investigated 110 patients with VF-OHCA who were admitted for treatment. We divided the patients based on ICD(n=71) or No-ICD status(n=39), and on reversible cause(n=70) or irreversible cause(n=40). The groups were compared for baseline characteristics, mortality and ICD therapies. Patients with a reversible cause had a signi cantly lower rate of ICD implantation than those with an irreversible cause(P=0.03). Males in the ICD group presented more frequently than those in the No-ICD group, and cardiac mortality in patients with acute coronary syndrome was signi cantly lower with ICD therapy than without ICD(P=0.04). The rate of appropriate ICD therapies with a reversible cause was 28%, and the rst ICD therapy was highest within 1 year post-implantation. Patients with VF-OHCA due to a reversible cause remain at high risk of recurrent ventricular arrhythmias, suggesting that ICD implantation is a reasonable approach in such cases.