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Cardiac Arrest in the Coronary Care Unit
Author(s) -
Conway D. H.,
McLean K. H.
Publication year - 1973
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.1973.tb03112.x
Subject(s) - medicine , coronary care unit , cardiology , resuscitation , ventricular fibrillation , anesthesia , myocardial infarction
Summary: An evaluation of the management of cardiac arrest in a Coronary Care Unit was made by studying the events surrounding a series of 46 cardiac arrests. Thirty four of these were due to ventricular tachyarrhythmias and 12 were caused by bradyarrhythmias. Investigation of the mode of recognition of the arrests showed that the unit relied heavily on human observers rather than electronic devices for the first indication of the occurrence of cardiac arrest. Antiarrhythmic drug therapy failed to prevent 12 of the 34 tachyarrhythmic arrests in this series. It is probable that three of the bradyarrhythmic arrests were precipitated by antiarrhythmic drugs. The ventricular ectopic activity preceding 28 of the tachyarrhythmic arrests was analysed from tape recorded monitor tracings. Twelve patients had frequent ventricular ectopic beats before their arrests, 11 patients had ectopic beats only infrequently, and five patients showed no ventricular ectopic activity at all in the period prior to arrest. The speed of resuscitation in the tachyarrhythmic arrests was estimated in terms of the duration of the arrhythmia until DC countershock occurred. It was found that the patients who received slower treatment had a higher mean age, and a higher hospital mortality than the others.