WEDNESDAY, May 31 (HealthDay News) -- Hospitalized children who experience cardiac arrest have a better outcome if either ventricular fibrillation or tachycardia are the initial pulseless rhythm rather than develop during the cardiac arrest, according to a study published in the June 1 issue of the New England Journal of Medicine.
Ricardo A. Samson, M.D., of the University of Arizona in Tucson, and colleagues studied 1,005 cardiac arrest patients, 272 (27 percent) of whom had documented ventricular fibrillation or tachycardia during the arrest. Of these, 104 had initial and 149 had subsequent ventricular fibrillation or tachycardia. In the other 19 patients, the time of initiation could not be determined.
Thirty-five percent of those with initial and 11 percent of those with subsequent ventricular fibrillation or tachycardia survived to hospital discharge (odds ratio, 2.6). They also found that 27 percent of those with no ventricular fibrillation or tachycardia survived to hospital discharge.
"The results emphasize the importance of early electrocardiographic monitoring during resuscitation, because the shockable rhythms of ventricular fibrillation or tachycardia occurred in more than 25 percent of these children," the authors state. "Even in the setting of progressive respiratory failure and shock, with an initial electrocardiogram showing asystole or pulseless electrical activity, subsequent shockable ventricular fibrillation or tachycardia developed in a substantial number of these children during CPR. Prompt, successful resuscitation from ventricular fibrillation requires electrocardiographic diagnosis and defibrillation."
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