Use of implantable cardioverter defibrillators in Canadian and US survivors of out-of-hospital cardiac arrest

Birnie, David H.; Sambell, Christie; Johansen, Helen; Williams, Kathryn; Lemery, Robert; Green, Martin S.; Gollob, Michael H.; Lee, Douglas S.; Tang, Anthony S. L.
July 2007
CMAJ: Canadian Medical Association Journal;7/3/2007, Vol. 177 Issue 1, p41
Academic Journal
Background: Cardiac arrest due to ventricular arrhythmia in the absence of a reversible cause or contraindication has been a class I indication for insertion of an implantable cardioverter defibrillator since 1998. We compared and contrasted the use of implantable cardioverter defibrillator therapy in Canada and the United States among adults who survived a cardiac arrest. Method: Data on hospital separations from April 1, 1994 through March 31, 2003 were obtained from the Health Person-Oriented Information Database maintained by Statistics Canada and from the US National Hospital Discharge Survey on all patients with a primary diagnosis of cardiac arrest, ventricular fibrillation or ventricular flutter for the same 9-year period. We excluded all records of patients with a secondary diagnosis of acute myocardial infarction. Results: In Canada, 3793 patients survived to discharge after a cardiac arrest; 628 (16.6%) of these were implanted with a cardioverter defibrillator before discharge. The implant rate rose steadily from 5.4% in 1994/95 to 26.7% in 2002/03. In the United States, 23 688 (30.2%) of 78 538 such survivors received an implantable cardioverter defibrillator before discharge. Logistic regression analysis indicated that sex, age, fiscal year, the hospital's teaching status, hospital size and patient history of heart failure were positive predictors of implantable cardioverter defibrillator implantation. Age, renal failure, liver failure and cancer were negative predictors of receiving an implantable cardioverter defibrillator. Interpretation: The rate of use of implantable cardioverter defibrillator therapy for cardiac arrest survivors in Canada is increasing, but still is lower than the rate in the United States.


Related Articles

  • Statistical Versus Individual Forecasting Of Life-Threatening Cardiac Arrhythmias. Wessel, Niels; Meyerfeldt, Udo; Ziehmann, Christine; Schirdewan, Alexander; Kurths, Ju¨rgen // AIP Conference Proceedings;2002, Vol. 622 Issue 1, p110 

    Ventricular tachycardia or fibrillation (VT) as fatal cardiac arrhythmias are the main factors triggering sudden cardiac death. The objective of this investigation is to find early signs of sustained VT in patients with an implanted cardioverter-defibrillator (ICD). These devices are able to...

  • An escalating higher-energy regimen was better than a fixed lower-energy regimen for defibrillation in out-of-hospital cardiac arrest.  // ACP Journal Club;Sept/Oct2007, Vol. 147 Issue 2, p33 

    The article presents a study to determine whether an escalating higher energy regimen was better than fixed lower-energy regimen for arrhythmia termination with an automated external defibrillator (AED) using a biphasic waveform in patients with out-of-hospital cardiac arrest. The study...

  • The "Beauty" of AEDs.  // Medical Update;2004, Vol. 29 Issue 8, p3 

    Focuses on automated external defibrillator (AED), a treatment for rhythm disorders in children. Definition of the condition called commotio cordis; Percentage of cardiac arrests that occurs in ventricular fibrillation in children over the age of five; Critical AED issue in pediatrics.

  • ECGs made easier than ever: Lethal strips. Hammond, Cecile // RN;Jan80, Vol. 43 Issue 1, p54 

    Provides information on premature ventricular contraction (PVC), caused by irritability in the ventricles. Occurrence of death from ventricular fibrillation; Most dangerous type of PVC; Treatment for ventricular fibrillation; Examples of dysrhythmias caused by ventricular irritability.

  • The Northern Ireland Public Access Defibrillation (NIPAD) study: effectiveness in urban and rural populations. Moore, M. J.; Hamilton, A. J.; Cairns, K. J.; Marshall, A.; Glover, B. M.; McCann, C. J.; Jordan, J.; Kee, F.; Adgey, A. A. J. // Heart;Dec2008, Vol. 94 Issue 12, p1614 

    Objective: To assess the impact of mobile automated external defibrillators (AEDs) on out-of-hospital cardiac arrests (OHCAs) in urban and rural populations. Design: Prospective before and after intervention, population study. Setting: Urban and rural areas of 160 000 each. Patients,...

  • Neurologic Recovery Following Prolonged Out-of-Hospital Cardiac Arrest With Resuscitation Guided by Continuous Capnography. WHITE, ROGER D.; GOODMAN, BRUCE W.; SVOBODA, MARY A. // Mayo Clinic Proceedings;Jun2011, Vol. 86 Issue 6, p544 

    A 54-year-old man with no known cardiac disease collapsed out- doors in a small rural community. The cardiac arrest was witnessed, and immediate cardiopulmonary resuscitation was be- gun by a bystander and a trained first responder who was nearby. The patient was moved into a building across the...

  • Beating the odds. Hayutin, Marnie // Cincinnati Magazine;Aug2005, Vol. 38 Issue 11, Special section p3 

    This article reports that implantable cardiac defibrillators are giving heart patients a second chance. It is informed that Sudden Cardiac Arrest (SCA) is the abrupt loss of heart function generally caused by a very rapid, irregular rhythm of the ventricles. This arrhythmia results in...

  • Ventricular arrhythmia, Cheyne-Stokes respiration, and death: observations from patients with defibrillators. Staniforth, A. D.; Sporton, S. C.; Earley, M. J.; Wedzicha, J. A.; Nathan, A. W.; Schilling, R. J. // Heart;Nov2005, Vol. 91 Issue 11, p1418 

    Objective: To determine whether ventricular arrhythmia related to nocturnal hypoxaemia during Cheyne-Stokes respiration (CSR) explains the observation that CSR is an independent marker of death in heart failure. Design: Prospective, observational study. Patients: 101 patients at high risk of...

  • Implantable Devices Reduce the Risks of Sudden Cardiac Arrest.  // Focus on Healthy Aging;Dec2012, Vol. 15 Issue 12, p1 

    The article reports on the results of a study which found that implantable cardioverter defibrillators (ICDs) can help reduce the risk of sudden cardia arrest due to ventricular fibrillation. It offers information on ICDs which regularly monitors the heart's rhythm and will restore normal rhythm...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics