Table 1 Interventions and their effect on outcome
Author(s) | Year | Study type | Population | Number | Intervention | Endpoint | Outcome | Grade of evidence (Table 2) |
|---|---|---|---|---|---|---|---|---|
Revascularisation | ||||||||
Bendz et al. [18] | 2004 | Prospective, observational | Cardiac arrest with STEMI | 40 | PCI | In-hospital and 2-year mortality | Favours PCI | 3 |
Borger van der Burg et al. [27] | 2003 | Prospective, observational | Cardiac arrest survivors | 142 | Surgical or PCI revascularisation | 4-year survival | Favours revascularisation | 2++ |
Cook et al. [25] | 2002 | AVID subgroup analysis | Mixed arrest/non-arrest. VF/VT, symptomatic VT. LVEF <0.4 | 281 | Surgical revascularisation | 2-year mortality | Reduced mortality in revascularised group. Additive benefit to ICD | 2++ |
Bigger [28] | 1997 | RCT | IHD, LVEF <0.36, abnormal ECG | 900 | Surgical revascularisation versus surgical revascularisation + ICD | Mortality | No advantage in ICD group | 1+ |
Spaulding et al. [22] | 1997 | Prospective cohort study | OOHCA survivors | 84 | PCI | In-hospital mortality | Favours PCI | 2+ |
Every et al. [24] | 1992 | Retrospective, observational | OOHCA survivors | 285 | Surgical revascularisation | Recurrence of cardiac arrest and mortality | Favours revascularisation | 2- |
Kelly et al. [26] | 1990 | Retrospective, observational | Post-arrest | 50 | Surgical revascularisation | Arrhythmia reduction | Reduction in inducible VF only | 2- |
Kaiser et al. [23] | 1975 | Retrospective, observational | OOHCA survivors | 11 | Surgical revascularisation | Mortality | Favours revascularisation | 3 |
ICD or antiarrhythmic agents | ||||||||
Nagahara et al. [17] | 2006 | Case-control | OOHCA survivors | 58 | ICD | Incidence of malignant arrhythmias | Favours ICD | 2- |
Bokhari et al. [47] | 2004 | RCT. Subgroup of CIDS study | Sustained VF/VT or cardiac arrest | 120 | Amiodarone or ICD | Mortality over 11-year follow-up | Favours ICD | 1+ |
Hennersdorf et al. [48] | 2003 | Prospective cohort | OOHCA survivors | 204 | ICD or antiarrhythmic agent | Mortality over mean follow-up of 5 years | Favours ICD | 2+ |
Connolly et al. [46] | 2000 | Meta-analysis | Mixed arrest/non-arrest ventricular arrhythmias | 1,866 | ICD versus antiarrhythmic drug | Mortality/arrhythmia | Favours ICD | 1- |
Kuck et al. [45] | 2000 | RCT | Cardiac arrest | 288 | ICD versus antiarrhythmic drug | Mortality/arrhythmia | Favours ICD | 1- |
Connolly et al. [44] | 2000 | RCT | Cardiac arrest-VF/VT/syncope | 659 | ICD versus antiarrhythmic drug | Mortality/arrhythmia recurrence | Favours ICD | 1- |
AVID [43] | 1997 | RCT | Mixed arrest/non-arrest. VF/VT, symptomatic VT. LVEF <0.4 | 1,016 | ICD versus antiarrhythmic drug | 2- and 3-year mortality and arrhythmia occurrence | Favours ICD | 1- |
Haverkamp et al. [35] | 1997 | Retrospective, observational | Inducible VF/VT and cardiac arrest survivors | 396 | Sotalol therapy | 1- and 3-year mortality and cardiac arrest occurrence | May not be as effective as ICD | 2- |
Buxton et al. [40] | 1999 | RCT | IHD and sustained inducible ventricular arrhythmias | 754 | Antiarrhythmic therapy versus conventional therapy | Cardiac arrest or death from arrhythmia | Favours antiarrhythmic therapy due to ICD | 1- |
Moss et al. [41] | 1996 | RCT | Previous MI, LVEF <0.35, ventricular arrhythmia | 196 | ICD versus conventional TX | Mortality | Favours ICD | 1- |
Wever et al. [49] | 1995 | RCT | Post-cardiac arrest due to old MI | 66 | ICD versus conventional TX | Mortality, hospital days, interventions | Favours ICD | 1- |
CASCADE [38] | 1993 | RCT | OOHCA non-Q wave | 228 | Amiodarone versus other antiarrhythmics | 2-year mortality | Higher survival in amiodarone group | 2+ |
Powell et al. [50] | 1993 | Retrospective, observational | Post-cardiac arrest due to ventricular arrhythmias | 336 | ICD | Mortality and sudden cardiac death | Favours ICD | 3 |
Crandall et al. [51] | 1993 | Retrospective, observational | Cardiac arrest with no inducible arrhythmia | 194 | ICD | Mortality and sudden cardiac death | Reduction in sudden change in overall mortality | 3 |
Hallstrom et al. [34] | 1991 | Retrospective, observational | OOHCA survivors | 941 | Antiarrhythmic agents | 2-year mortality | Increased mortality in patients given prophylactic antiarrhythmics | 2- |
Moosvi et al. [36] | 1990 | Retrospective, observational | OOHCA survivors with CHD | 209 | Quinidine or procainamide or no antiarrhythmic therapy | Incidence of sudden death | Increased sudden death in empiric antiarrhythmic therapy | 2- |
Myerburg et al. [37] | 1977 | Case series | OOHCA survivors | 12 | Quinidine or procainamide | 1-year mortality | Favours antiarrhythmic therapy | 3 |
Therapeutic hypothermia | ||||||||
Holzer et al. [81] | 2005 | Meta-analysis | Post-cardiac arrest | 385 | Therapeutic hypothermia | Hospital and 6-month survival and neurological outcome | Favours therapeutic hypothermia | 1- |
HACA Group [79] | 2002 | RCT | Post-OOH VF cardiac arrest | 275 | Therapeutic hypothermia | 6-month mortality and neurological outcome | Reduced mortality and better neurological outcome | 1+ |
Bernard et al. [69] | 2002 | RCT | Post-OOH VF arrest | 77 | Therapeutic hypothermia | Hospital mortality and neurological outcome | Reduced mortality and better neurological outcome | 1+ |
Nagao et al. [71] | 2000 | Prospective cohort | OOHCA patients | 23 | Therapeutic hypothermia | Cerebral performance | Good neurological outcome | 2- |
Yanagawa et al. [77] | 1998 | Prospective case-control | OOHCA patients | 28 | Therapeutic hypothermia | Hospital mortality and neurological outcome | Improved survival and neurological outcome | 2+ |
Bernard et al. [78] | 1997 | Prospective case-control | OOHCA patients | 44 | Therapeutic hypothermia | Hospital mortality and neurological outcome | Improved survival and neurological outcome | 2+ |