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09.08.2023 | EM - ORIGINAL

Amplitude spectral area of ventricular fibrillation and defibrillation success at low energy in out-of-hospital cardiac arrest

verfasst von: Francesca R. Gentile, Lars Wik, Iraia Isasi, Enrico Baldi, Elisabete Aramendi, Jon Erik Steen-Hansen, Alessandro Fasolino, Sara Compagnoni, Enrico Contri, Alessandra Palo, Roberto Primi, Sara Bendotti, Alessia Currao, Federico Quilico, Luca Vicini Scajola, Clara Lopiano, Simone Savastano

Erschienen in: Internal and Emergency Medicine | Ausgabe 8/2023

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Abstract

The optimal energy for defibrillation has not yet been identified and very often the maximum energy is delivered. We sought to assess whether amplitude spectral area (AMSA) of ventricular fibrillation (VF) could predict low energy level defibrillation success in out-of-hospital cardiac arrest (OHCA) patients. This is a multicentre international study based on retrospective analysis of prospectively collected data. We included all OHCAs with at least one manual defibrillation. AMSA values were calculated by analyzing the data collected by the monitors/defibrillators used in the field (Corpuls 3 and Lifepak 12/15) and using a 2-s-pre-shock electrocardiogram interval. We run two different analyses dividing the shocks into three tertiles (T1, T2, T3) based on AMSA values. 629 OHCAs were included and 2095 shocks delivered (energy ranging from 100 to 360 J; median 200 J). Both in the “extremes analysis” and in the “by site analysis”, the AMSA values of the effective shocks at low energy were significantly higher than those at high energy (p = 0.01). The likelihood of shock success increased significantly from the lowest to the highest tertile. After correction for age, call to shock time, use of mechanical CPR, presence of bystander CPR, sex and energy level, high AMSA value was directly associated with the probability of shock success [T2 vs T1 OR 3.8 (95% CI 2.5–6) p < 0.001; T3 vs T1 OR 12.7 (95% CI 8.2–19.2), p < 0.001]. AMSA values are associated with the probability of low-energy shock success so that they could guide energy optimization in shockable cardiac arrest patients.

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Titel: Amplitude spectral area of ventricular fibrillation and defibrillation success at low energy in out-of-hospital cardiac arrest
verfasst von: Francesca R. Gentile
Lars Wik
Iraia Isasi
Enrico Baldi
Elisabete Aramendi
Jon Erik Steen-Hansen
Alessandro Fasolino
Sara Compagnoni
Enrico Contri
Alessandra Palo
Roberto Primi
Sara Bendotti
Alessia Currao
Federico Quilico
Luca Vicini Scajola
Clara Lopiano
Simone Savastano
Publikationsdatum: 09.08.2023
Verlag: Springer International Publishing
Erschienen in: Internal and Emergency Medicine / Ausgabe 8/2023
Print ISSN: 1828-0447
Elektronische ISSN: 1970-9366
DOI: https://doi.org/10.1007/s11739-023-03386-6

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