• Mari Amino, Sadaki Inokuchi, Koichiro Yoshioka, Yoshihide Nakagawa, Yuji Ikari, Hiraku Funakoshi, Katsura Hayakawa, Masakazu Matsuzaki, Atsushi Sakurai, Yoshio Tahara, Naohiro Yonemoto, Ken Nagao, Arino Yaguchi, Naoto Morimura, and SOS-KANTO 2012 study group.
• *Tokai University School of Medicine, Kanagawa, Japan;†Tokyo Bay Urayasu/Ichikawa Medical Center, Chiba, Japan;‡Saitama Red Cross Hospital, Saitama, Japan;§Nihon University Surugadai Hospital, Tokyo, Japan;¶Nihon University School of Medicine, Tokyo, Japan;‖National Cerebral and Cardiovascular Center Hospital, Osaka, Japan;**National Center of Neurology and Psychiatry, Tokyo, Japan;††Tokyo Women's Medical University Hospital, Tokyo, Japan; and‡‡Yokohama City University Medical Center, Kanagawa, Japan.
• J. Cardiovasc. Pharmacol. 2016 Jul 1; 68 (1): 58-66.

BackgroundAntiarrhythmic drugs (AAD) are often used for fatal ventricular arrhythmias during cardiopulmonary resuscitation (CPR). However, the efficacy of initial AAD administration during CPR in improving long-term prognosis remains unknown. This study retrospectively evaluated the effect of AAD administration during CPR on 1-month prognosis in the SOS-KANTO 2012 study population.Methods And ResultsOf the 16,164 out-of-hospital cardiac arrest cases, 1350 shock-refractory patients were included: 747 patients not administered AAD and 603 patients administered AAD. Statistical adjustment for potential selection bias was performed using propensity score matching, yielding 1162 patients of whom 792 patients were matched (396 pairs). The primary outcome was 1-month survival. The secondary outcome was the proportion of patients with favorable neurological outcome at 1 month. Logistic regression with propensity scoring demonstrated an odds ratio (OR) for 1-month survival in the AAD group of 1.92 (P < 0.01), whereas the OR for favorable neurological outcome at 1 month was 1.44 (P = 0.26).ConclusionsSignificantly greater 1-month survival was observed in the AAD group compared with the non-AAD group. However, the effect of ADD on the likelihood of a favorable neurological outcome remains unclear. The findings of the present study may indicate a requirement for future randomized controlled trials evaluating the effect of ADD administration during CPR on long-term prognosis.

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