Survivors of ventricular tachyarrhythmias due to a transient or reversible disorder have a high recurrence rate of lethal cardiac events.

Abstract

The recurrence rate of lethal cardiac events after the survival of a primary cardiac arrest in patients not having received an implantable cardioverter defibrillator (ICD) is investigated. According to current guidelines, only a small percentage of patients after successful cardiopulmonary resuscitation due to an underlying cardiac problem are eligible for the implantation of an ICD. For retrospective analysis, we used a data registry of patients admitted to an emergency department after cardiac arrest. Patients who had a primary cardiac cause for their cardiac arrest and who did not die within the first month after successful restoration of spontaneous circulation were selected. From 1246 patients, 360 met the inclusion criteria. A second lethal cardiac event occurred in 94 (26%). Of those 94 patients, 57 (61%) had good neurological function before their second cardiac arrest. Of the survivors with good neurological function, 47 (82%) did not have an ICD or a cardiac transplant. Another cardiac arrest due to a primary cardiac event occurred in 34 (72%) of these patients. Cardiac arrest survivors without an apparent indication for an ICD have a high risk of suffering from a re-arrest of cardiac origin.