Current practice in out-of-hospital cardiac arrest management: a european heart rhythm association EP network survey

The purpose of this EP wire is to examine clinical practice in the field of out-of-hospital cardiac arrest (OHCA) management, with special focus on in-hospital diagnostic and therapeutic strategies. Fifty-three European centres, all members of the EHRA-EP Research network, completed the questions of the survey. A dedicated strategy for OHCA management is active in 85 of the centres. Shockable tachyarrhythmias such as initial OHCA rhythm are reported in 70 of the patients in 64 of the centres. In-hospital therapeutic hypothermia was applied in 50 of the patients in 53 of the centres and in 50 in 47 of the centres. In the year 2011 90 of the centres performed 10 primary percutaneous coronary angioplasties (PCI) in OHCA patients. The survival rate, when the initial documented rhythm was shockable, was 30 in 42 of the centres, and conversely, was significantly lower when asystole or pulseless electrical activity was the initial rhythm. A favourable neurological recovery was reported in 50 of the patients in 13 (26) centres and in 2150 of the patients in 21 (44). This EP wire survey demonstrates a favourable implementation in OHCA of an invasive management strategy, including coronary angiography/PCI and implantable cardioverter defibrillator therapy, while therapeutic hypothermia appears to be underused.