Journal of the American College of Cardiology
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Survival to hospital discharge was related to the clinical history and emergency care system factors in 285 patients with witnessed cardiac arrest due to ventricular fibrillation. Only the emergency care factors were associated with differences in outcome. ⋯ Expected survival rates were higher with early defibrillation (38 +/- 3%; 95% confidence limits) than the observed rate (28 +/- 3%). Because outcome from cardiac arrest is primarily influenced by delays in providing cardiopulmonary resuscitation and defibrillation, factors affecting response time should be carefully examined by all emergency care systems.
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J. Am. Coll. Cardiol. · Apr 1986
Comparative StudyTwenty-four hour survival in a canine model of cardiac arrest comparing three methods of manual cardiopulmonary resuscitation.
Two new modifications of manual cardiopulmonary resuscitation, high impulse compression at a rate of 120/min and interposed abdominal compression at a rate of 60/min, have been reported to produce better hemodynamic responses than standard cardiopulmonary resuscitation at 60/min. However, the effect of these two new methods on initial resuscitation success and 24 hour survival is unknown. In this study, 30 mongrel dogs were divided into three equal groups, each treated with one of three types of manual cardiopulmonary resuscitation. ⋯ There was no difference in initial resuscitation success, 24 hour survival or neurologic deficit of the survivors among the three manual cardiopulmonary resuscitation methods. Aortic diastolic and calculated coronary perfusion pressures were similar for all three methods. Well performed standard manual cardiopulmonary resuscitation is as effective as these modified versions (high impulse compression and interposed abdominal compression) when compared in the same animal model.
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J. Am. Coll. Cardiol. · Apr 1986
Case ReportsCombined bipolar dual chamber pacing and automatic implantable cardioverter/defibrillator.
A 67 year old man with recurrent hypotensive ventricular tachycardia, amiodarone-induced bradyarrhythmias and severe cardiac dysfunction underwent simultaneous implantation of an automatic cardioverter/defibrillator and bipolar atrioventricular (AV) pacemaker. The pacing electrodes were placed epicardially near the right atrial appendage and on the lateral right ventricular wall. ⋯ Long-term follow-up study confirmed the safety of this treatment. With proper precautions, bipolar AV pacing can be safely combined with an automatic cardioverter/defibrillator.