Ventricular Tachycardia More Common in Public Settings

Incidence of the arrhythmia lower in those whose arrests witnessed at home

THURSDAY, Jan. 27 (HealthDay News) -- Ventricular fibrillation or pulseless ventricular tachycardia happens more frequently when cardiac arrests are witnessed in a public setting as opposed to at home, according to research published in the Jan. 27 issue of the New England Journal of Medicine.

Myron L. Weisfeldt, M.D., from Johns Hopkins University in Baltimore, and colleagues assessed 12,930 out-of-hospital cardiac arrests that occurred between 2005 and 2007 -- 2,042 of which occurred in public and 9,564 at home -- to determine the association between settings, type of arrhythmia, and likelihood of survival.

The researchers found that, for cardiac arrests that happened at home, the incidence of pulseless ventricular tachycardia or ventricular fibrillation was 25 percent when witnessed by emergency medical services (EMS) personnel, 35 percent when witnessed by a bystander, and 36 percent when a bystander used an automated external defibrillator (AED). The corresponding rates for cardiac arrests witnessed in public were 38, 60, and 79 percent. The researchers found that the rate of survival to hospital discharge was 12 percent for arrests at home and 34 percent for arrests in public with AEDs applied by bystanders.

"Regardless of whether out-of-hospital cardiac arrests are witnessed by EMS personnel or bystanders and whether AEDs are applied by bystanders, the proportion of arrests with initial ventricular fibrillation or pulseless ventricular tachycardia is much greater in public settings than at home. The incremental value of resuscitation strategies, such as the ready availability of an AED, may be related to the place where the arrest occurs," the authors write.

Two authors disclosed financial relationships with a medical device company; one author disclosed receiving royalties from a patent on a pacemaker.

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