WJCD  Vol.5 No.8 , August 2015
Is There Still a Place for Post-Resuscitation Electrocardiogram for Therapeutic Management and Coronary Angiogram Indication after Out-of-Hospital Cardiac Arrest?
Out-of-hospital cardiac arrest is a common cause of death. Some therapeutic strategies performed daily are still debated, including particularly emergency coronary angiography independently of the clinical pattern. Primary percutaneous coronary intervention seems the strategy of choice in ST-segment elevation myocardial infarction but in other clinical presentations, benefit of coronary angiogram remains controversial. To improve management of out-of-hospital cardiac arrest and define the best timing to perform coronary angiogram, we suggest a study design based on ECG evaluation to define predictors of coronary artery disease after resuscitated cardiac arrest by distinguishing 3 groups according to ECG after resuscitation: ST segment elevation and LBBB; repolarisation disorder or no repolarisation disorder. Evaluation of ECG changes may still be useful as a triage method for establishing the indication for emergency coronary angiogram due to easy, non invasive and quick method and thus for limiting complications associated with this exam in acute phase.

Cite this paper
Lonjon, C. , Lattuca, B. , Roubille, F. , Cayla, G. and Leclercq, F. (2015) Is There Still a Place for Post-Resuscitation Electrocardiogram for Therapeutic Management and Coronary Angiogram Indication after Out-of-Hospital Cardiac Arrest?. World Journal of Cardiovascular Diseases, 5, 203-210. doi: 10.4236/wjcd.2015.58023.
[1]   Eisenberg, M.S. and Mengert, T.J. (2001) Cardiac Resuscitation. New England Journal of Medicine, 344, 1304-1313.

[2]   Rea, T.D., Eisenberg, M.S., Sinibaldi, G. and White, R.D. (2004) Incidence of EMS-Treated Out-of-Hospital Cardiac Arrest in the United States. Resuscitation, 63, 17-24.

[3]   Atwood, C., Eisenberg, M.S., Herlitz, J. and Rea, T.D. (2005) Incidence of EMS-Treated Out-of-Hospital Cardiac Arrest in Europe. Resuscitation, 67, 75-80.

[4]   Anyfantakis, Z.A., Baron, G., Aubry, P., Himbert, D., Feldman, L.J., Juliard, J.-M., et al. (2009) Acute Coronary Angiographic Findings in Survivors of Out-of-Hospital Cardiac Arrest. American Heart Journal, 157, 312-318.

[5]   Dumas, F., White, L., Stubbs, B.A., Cariou, A. and Rea, T.D. (2012) Long-Term Prognosis Following Resuscitation from Out of Hospital Cardiac Arrest: Role of Percutaneous Coronary Intervention and Therapeutic Hypothermia. Journal of the American College of Cardiology, 60, 21-27.

[6]   Dumas, F., Cariou, A., Manzo-Silberman, S., Grimaldi, D., Vivien, B., Rosencher, J., et al. (2010) Immediate Percutaneous Coronary Intervention Is Associated with Better Survival after Out-of-Hospital Cardiac Arrest: Insights from the PROCAT (Parisian Region Out of hospital Cardiac ArresT) Registry. Circulation: Cardiovascular Interventions, 3, 200-207.

[7]   Spaulding, C.M., Joly, L.M., Rosenberg, A., Monchi, M., Weber, S.N., Dhainaut, J.F., et al. (1997) Immediate Coronary Angiography in Survivors of Out-of-Hospital Cardiac Arrest. New England Journal of Medicine, 336, 1629-1633.

[8]   RéAC, Registre électronique des Arrêts Cardiaques.

[9]   2014 ESC/EACTS. Guidelines in Myocardial Revascularisation (Guidelines for).

[10]   (2012) ESC Guidelines for the Management of Acute Myocardial Infarction in Patients Presenting with ST-Segment Elevation. European Heart Journal, 33, 2569-2619.

[11]   Bernard, S.A., Gray, T.W., Buist, M.D., Jones, B.M., Silvester, W., Gutteridge, G., et al. (2002) Treatment of Comatose Survivors of Out-of-Hospital Cardiac Arrest with Induced Hypothermia. New England Journal of Medicine, 346, 557-563.

[12]   Clinkard, D., Cameron, A., Howes, D. and Ball, I. (2015) Targeted Temperature Management: It Is Not Yet Time to Change Your Target Temperature. CJEM, 1-3.

[13]   Belliard, G., Catez, E., Charron, C., Caille, V., Aegerter, P., Dubourg, O., et al. (2007) Efficacy of Therapeutic Hypothermia after Out-of-Hospital Cardiac Arrest Due to Ventricular Fibrillation. Resuscitation, 75, 252-259.

[14]   Zheng, Z.J., Croft, J.B., Giles, W.H. and Mensah, G.A. (2001) Sudden Cardiac Death in the United States, 1989 to 1998. Circulation, 104, 2158-2163.

[15]   Zipes, D.P. and Wellens, H.J.J. (1998) Sudden Cardiac Death. Circulation, 98, 2334-2351.

[16]   Pell, J.P., Sirel, J.M., Marsden, A.K., Ford, I., Walker, N.L. and Cobbe, S.M. (2003) Presentation, Management, and Outcome of Out of Hospital Cardiopulmonary Arrest: Comparison by Underlying Aetiology. Heart, 89, 839-842.

[17]   Davies, M.J. (1992) Anatomic Features in Victims of Sudden Coronary Death. Coronary Artery Pathology. Circulation, 85, I19-I24.

[18]   Sideris, G., Voicu, S., Dillinger, J.G., Stratiev, V., Logeart, D., Broche, C., et al. (2011) Value of Post-Resuscitation Electrocardiogram in the Diagnosis of Acute Myocardial Infarction in Out-of-Hospital Cardiac Arrest Patients. Resuscitation, 82, 1148-1153.

[19]   Thygesen, K., Alpert, J.S., Jaffe, A.S., Simoons, M.L., Chaitman, B.R., White, H.D., et al. (2012) Third Universal Definition of Myocardial Infarction. Global Heart, 7, 275-295.

[20]   Menown, I.B., Mackenzie, G. and Adgey, A.A. (2000) Optimizing the Initial 12-Lead Electrocardiographic Diagnosis of Acute Myocardial Infarction. European Heart Journal, 21, 275-283.

[21]   Kahn, J.K., Glazier, S., Swor, R., Savas, V. and O’Neill, W.W. (1995) Primary Coronary Angioplasty for Acute Myocardial Infarction Complicated by Out-of-Hospital Cardiac Arrest. The American Journal of Cardiology, 75, 1069-1070.

[22]   Bendz, B., Eritsland, J., Nakstad, A.R., Brekke, M., Klow, N.E., Steen, P.A., et al. (2004) Long-Term Prognosis after Out-of-Hospital Cardiac Arrest and Primary Percutaneous Coronary Intervention. Resuscitation, 63, 49-53.