Long-term antiarrhythmic therapy in survivors of prehospital cardiac arrest. Initial 18 months' experience
R. J. Myerburg, F. W. Briese, C. Conde, S. M. Mallon, R. R. Liberthson and A. Castellanos Jr
Ambulatory rhythm monitoring and chronic arrhythmia management were studied
in 16 patients resuscitated from prehospital cardiac arrest. Asymptomatic
complex ventricular arrhythmias (ACVA) occurred in 12 patients (75%)
entering long-term follow-up during the first 12 months (average follow-up,
13.25 months). The patients' therapy consisted of a dose-adjusted,
membrane-active antiarrhythmic drug regimen monitored by blood levels.
While there has been little change in the frequency of ACVAs despite
carefully controlled antiarrhythmic management, only one death has occurred
during 212 patient-months of postarrest follow-up, a 6% one-year mortality.
This compares favorably to our previous experience in survivors of
prehospital cardiac arrest not receiving a controlled antiarrhythmic
program. Despite the failure to suppress ACVAs, the drug-monitored
population is showing a trend toward a decreased frequency of recurrent
cardiac arrest.
