Antiarrhythmic - Class I (Na+ channel blockers)
Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
I
|
Supportive (Green)
|
ROSC
|
Patient
|
|
McLeod SL., Brignardello-Petersen R., Worster A., You J., Iansavichene A., Guyatt G., et al. Comparative effectiveness of antiarrhythmics for out-of-hospital cardiac arrest: A systematic review and network meta-analysis. Resuscitation 2017; 121:90-7. Medline
|
I
|
Supportive (Green)
|
Organized electrical rhythm
|
Patient
|
ED-MD
|
Olson DW., Thompson BM., Darin JC., Milbrath MH. A randomized comparison study of bretylium tosylate and lidocaine in resuscitation of patients from out-of-hospital ventricular fibrillation in a paramedic system. Ann Emerg Med 1984; 13(9 Pt 2):807-10. Medline
|
I
|
Supportive (Green)
|
survival to hospital
|
Patient
|
ED-Paramedic & CCP
|
Rahimi M, Dorian P, Cheskes S, Lebovic G, Lin S. Effect of Time to Treatment With Antiarrhythmic Drugs on Return of Spontaneous Circulation in Shock-Refractory Out-of-Hospital Cardiac Arrest. J Am Hear Assoc 2022; 11(6):e023958. Medline
|
I
|
Neutral (Yellow)
|
Survival to hospital discharge
|
Patient
|
|
Kudenchuk PJ., Brown SP., Daya M., et al. Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. N Engl J Med 2016; 374(18):1711-22. Medline
|
I
|
Neutral (Yellow)
|
Survival to discharge
|
Patient
|
|
Kudenchuk PJ., Leroux BG., Daya M., Rea T., Vaillancourt C., Morrison LJ., et al. Antiarrhythmic Drugs for Nonshockable-Turned-Shockable Out-of-Hospital Cardiac Arrest: The ALPS Study (Amiodarone, Lidocaine, or Placebo). Circulation 2017; 136(22):2119-31. Medline
|
I
|
Neutral (Yellow)
|
Survival to discharge
|
Patient
|
PH-Paramedic
|
Lane DJ, Grunau B, Kudenchuk P, Dorian P, Wang HE, et al. Bayesian analysis of amiodarone or lidocaine versus placebo for out-of-hospital cardiac arrest. Heart 2022. Medline
|
I
|
Neutral (Yellow)
|
survival to hospital admission
|
Patient
|
PH-Paramedic
|
Ong ME., Pellis T., Link MS. The use of antiarrhythmic drugs for adult cardiac arrest: a systematic review. Resuscitation 2011; 82(6):665-70. Medline
|
I
|
Neutral (Yellow)
|
ROSC Achieved
|
Patient
|
PH-Paramedic
|
Rahimi M, Dorian P, Cheskes S, Lebovic G, Lin S. Effect of Time to Treatment With Antiarrhythmic Drugs on Return of Spontaneous Circulation in Shock-Refractory Out-of-Hospital Cardiac Arrest. J Am Hear Assoc 2022; 11(6):e023958. Medline
|
I
|
Opposes (Red)
|
Return of an organized rhythm
|
Patient
|
PH-Paramedic
|
Haynes RE., Chinn TL., Copass MK., Cobb LA. Comparison of bretylium tosylate and lidocaine in management of out of hospital ventricular fibrillation: A randomized clinical trial. Am J Cardiol 1981; 48(2):353-6. Medline
|
II
|
Supportive (Green)
|
1 month survival
|
Patient
|
|
Amino M, Inokuchi S, Yoshioka K, Nakagawa Y, Ikari Y, Funakoshi H, et al. Does Antiarrhythmic Drug During Cardiopulmonary Resuscitation Improve the One-month Survival: The SOS-KANTO 2012 Study. J Cardiovasc Pharmacol; 68(1):58-66. Medline
|
II
|
Supportive (Green)
|
1-year mortality.
|
Patient
|
|
Huang CH., Yu PH., Tsai MS., Chuang PY., Wang TD., Chiang CY., et al. Acute hospital administration of amiodarone and/or lidocaine in shockable patients presenting with out-of-hospital cardiac arrest: A nationwide cohort study. Int J Cardiol 2017; 227:292-8. Medline
|
II
|
Supportive (Green)
|
30-day OHCA survival.
|
Patient
|
PH-Paramedic
|
Kishihara Y, Kashiura M, Amagasa S, Fukushima F, Yasuda H, Moriya T. Comparison of the effects of lidocaine and amiodarone for out-of-hospital cardiac arrest patients with shockable rhythms: a retrospective observational study from a multicenter registry. BMC Cardiovasc Disord Nov 2022; 22(1):466. Medline
|
II
|
Supportive (Green)
|
Survival to discharge
|
Patient
|
PH-Paramedic
|
Lupton JR, Neth MR, Sahni R, Jui J, Wittwer L, Newgard CD, Daya MR. Survival by Time-to-Administration of Amiodarone, Lidocaine, or Placebo in Shock-Refractory Out-of-Hospital Cardiac Arrest. Acad Emerg Med March 2023. Medline
|
II
|
Supportive (Green)
|
Survival
|
Patient
|
In-Patient
|
Wagner D, Kronick SL, Nawer H, Cranford JA, Bradley SM, Neumar RW. Comparative Effectiveness of Amiodarone and Lidocaine for the Treatment of In-Hospital Cardiac Arrest. Chest 2023; 163(5):1109-19. Medline
|
II
|
Neutral (Yellow)
|
Survival outcomes (ROSC and survival to discharge)
|
Patient
|
PH-Paramedic
|
Huang Y., He Q., Yang M., Zhan L. Antiarrhythmia drugs for cardiac arrest: A systemic review and meta-analysis. Crit Care 2013; 17(4):R173. Medline
|
II
|
Neutral (Yellow)
|
Re-arrest
|
Patient
|
|
Salcido DD., Schmicker RH., Kime N., Buick JE., Cheskes S., Grunau B., et al. Effects of intra-resuscitation antiarrhythmic administration on rearrest occurrence and intra-resuscitation ECG characteristics in the ROC ALPS trial. Resuscitation 2018;129:6-12. Medline
|
II
|
Neutral (Yellow)
|
Survival at hospital admission
|
Patient
|
|
Sanfilippo F., Corredor C., Santonocito C., Panarello G., Arcadipane A., Ristagno G., et al. Amiodarone or lidocaine for cardiac arrest: A systematic review and meta-analysis. Resuscitation 2016; 107:31-7. Medline
|
II
|
Neutral (Yellow)
|
Increased hospital admission
|
Patient
|
ED-MD
|
Tagami T., Matsui H., Ishinokami S., Oyanagi M., Kitahashi A., Fukuda R., et al. Amiodarone or nifekalant upon hospital arrival for refractory ventricular fibrillation after out-of-hospital cardiac arrest. Resuscitation 2016;109:127-32. Medline
|
III
|
Neutral (Yellow)
|
ROSC
|
Patient
|
PH-Paramedic
|
Huebinger R, Harvin JA, Chan HK, Idris A, Cooper B, Giordano J, Wang HE. Procainamide for shockable rhythm cardiac arrest in the Resuscitation Outcome Consortium. Am J Emerg Med 2022; 55:143–6. Medline
|
III
|
Neutral (Yellow)
|
Feasibility
|
Process
|
PH-Paramedic & CCT
|
Kovoor P., Love A., Hall J., Sadnick N., et al. Randomized double-blind trial of sotalol vs lignocaine in out-of-hospital refractory cardiac arrest due to ventricular tachyarrhythmia. Intern Med J 2005; 35(9):518-25. Medline
|
III
|
Neutral (Yellow)
|
Survival time
|
Patient
|
PH-Paramedic
|
Wang HE., Min A., Hostler D., Chang CC., Callaway CW. Differential effects of out-of-hospital interventions on short- and long-term survival after cardiopulmonary arrest. Resuscitation 2005; 67(1):69-74. Medline
|
Antiarrhythmic - Class III (K+ channel blockers)
Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
I
|
Supportive (Green)
|
Survival to hospital discharge
|
Patient
|
PH-Paramedic
|
Lane DJ, Grunau B, Kudenchuk P, Dorian P, Wang HE, et al. Bayesian analysis of amiodarone or lidocaine versus placebo for out-of-hospital cardiac arrest. Heart 2022. Medline
|
I
|
Supportive (Green)
|
ROSC
|
Patient
|
|
McLeod SL., Brignardello-Petersen R., Worster A., You J., Iansavichene A., Guyatt G., et al. Comparative effectiveness of antiarrhythmics for out-of-hospital cardiac arrest: A systematic review and network meta-analysis. Resuscitation 2017; 121:90-7. Medline
|
I
|
Supportive (Green)
|
Probability of survival to discharge
|
Patient
|
ED-Paramedic & CCP
|
Rahimi M, Dorian P, Cheskes S, Lebovic G, Lin S. Effect of Time to Treatment With Antiarrhythmic Drugs on Return of Spontaneous Circulation in Shock-Refractory Out-of-Hospital Cardiac Arrest. J Am Hear Assoc 2022; 11(6):e023958. Medline
|
I
|
Neutral (Yellow)
|
Survival to hospital admission
|
Process
|
PH-Paramedic
|
Dorian P., et al. Amiodarone as Compared With Lidocaine for Shock-Resistant Ventricular Fibrillation. N Engl J Med 2002; 346(12); 884-9. Medline
|
I
|
Neutral (Yellow)
|
Survival to hospital admission
|
Patient
|
PH-Paramedic
|
Kudenchuk P., Cobb L., Copass M., et al. Amiodarone for resuscitation after out-of-hospital cardiac arrest due to ventricular fibrillation. N Engl J Med 1999; 234:871-8. Medline
|
I
|
Neutral (Yellow)
|
Survival to hospital discharge
|
Patient
|
|
Kudenchuk PJ., Brown SP., Daya M., et al. Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. N Engl J Med 2016; 374(18):1711-22. Medline
|
I
|
Neutral (Yellow)
|
Survival to hospital discharge
|
Patient
|
|
Kudenchuk PJ., Brown SP., Daya M., et al. Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. N Engl J Med 2016; 374(18):1711-22. Medline
|
I
|
Neutral (Yellow)
|
Survival to discharge
|
Patient
|
|
Kudenchuk PJ., Leroux BG., Daya M., Rea T., Vaillancourt C., Morrison LJ., et al. Antiarrhythmic Drugs for Nonshockable-Turned-Shockable Out-of-Hospital Cardiac Arrest: The ALPS Study (Amiodarone, Lidocaine, or Placebo). Circulation 2017; 136(22):2119-31. Medline
|
II
|
Supportive (Green)
|
1 month survival
|
Patient
|
|
Amino M, Inokuchi S, Yoshioka K, Nakagawa Y, Ikari Y, Funakoshi H, et al. Does Antiarrhythmic Drug During Cardiopulmonary Resuscitation Improve the One-month Survival: The SOS-KANTO 2012 Study. J Cardiovasc Pharmacol; 68(1):58-66. Medline
|
II
|
Supportive (Green)
|
1-year mortality.
|
Patient
|
|
Huang CH., Yu PH., Tsai MS., Chuang PY., Wang TD., Chiang CY., et al. Acute hospital administration of amiodarone and/or lidocaine in shockable patients presenting with out-of-hospital cardiac arrest: A nationwide cohort study. Int J Cardiol 2017; 227:292-8. Medline
|
II
|
Supportive (Green)
|
30 day survival post VF/VT cardiac arrest
|
Patient
|
PH-Paramedic
|
Kishihara Y, Kashiura M, Amagasa S, Fukushima F, Yasuda H, Moriya T. Comparison of the effects of lidocaine and amiodarone for out-of-hospital cardiac arrest patients with shockable rhythms: a retrospective observational study from a multicenter registry. BMC Cardiovasc Disord Nov 2022; 22(1):466. Medline
|
II
|
Supportive (Green)
|
Survival to hospital discharge
|
Patient
|
PH-Paramedic
|
Lupton JR, Neth MR, Sahni R, Jui J, Wittwer L, Newgard CD, Daya MR. Survival by Time-to-Administration of Amiodarone, Lidocaine, or Placebo in Shock-Refractory Out-of-Hospital Cardiac Arrest. Acad Emerg Med March 2023. Medline
|
II
|
Supportive (Green)
|
Increased hospital admission
|
Process
|
|
Tagami T., Matsui H., Ishinokami S., Oyanagi M., Kitahashi A., Fukuda R., et al. Amiodarone or nifekalant upon hospital arrival for refractory ventricular fibrillation after out-of-hospital cardiac arrest. Resuscitation 2016;109:127-32. Medline
|
II
|
Supportive (Green)
|
Defib rate, Rhythm conversion
|
Process
|
ED-MD
|
Yoshioka K., Amino M., Morita S., et al. Can nifekalant hydrochloride be used as a first-line drug for cardiopulmonary arrest (CPA)? : Comparative study of out-of-hospital CPA with acidosis and in-hospital CPA without acidosis. Circ J 2006; 70(1):21-27. Medline
|
II
|
Neutral (Yellow)
|
Defib success
|
Patient
|
PH-Paramedic
|
Amino M., Yoshioka K., Opthof T., et al. Comparative study of nifekalant versus amiodarone for shock-resistant ventricular fibrillation in out-of-hospital cardiopulmonary arrest patients. J Cardiovasc Pharmacol 2010; 55(4):391-8. Medline
|
II
|
Neutral (Yellow)
|
ROSC
|
Process
|
PH-Paramedic
|
Harayama N., Nihei SI., Nagata K., et al. Comparison of nifekalant and amiodarone for resuscitation of out-of-hospital cardiopulmonary arrest resulting from shock-resistant ventricular fibrillation. J Anesth 2014; 28(4):587-92. Medline
|
II
|
Neutral (Yellow)
|
Survival outcomes (ROSC and survival to discharge)
|
Patient
|
PH-Paramedic
|
Huang Y., He Q., Yang M., Zhan L. Antiarrhythmia drugs for cardiac arrest: A systemic review and meta-analysis. Crit Care 2013; 17(4):R173. Medline
|
II
|
Neutral (Yellow)
|
Survival to discharge
|
Patient
|
PH-Paramedic
|
Perry E, Nehme E, Stub D, Anderson D, Nehme Z. The impact of time to amiodarone administration on survival from out-of-hospital cardiac arrest. Resusc Plus 2023; 14:100405. Medline
|
II
|
Neutral (Yellow)
|
ROSC in cardiac arrest
|
Patient
|
PH-Paramedic
|
Rahimi M, Dorian P, Cheskes S, Lebovic G, Lin S. Effect of Time to Treatment With Antiarrhythmic Drugs on Return of Spontaneous Circulation in Shock-Refractory Out-of-Hospital Cardiac Arrest. J Am Hear Assoc 2022; 11(6):e023958. Medline
|
II
|
Neutral (Yellow)
|
Re-arrest
|
Patient
|
|
Salcido DD., Schmicker RH., Kime N., Buick JE., Cheskes S., Grunau B., et al. Effects of intra-resuscitation antiarrhythmic administration on rearrest occurrence and intra-resuscitation ECG characteristics in the ROC ALPS trial. Resuscitation 2018;129:6-12. Medline
|
II
|
Neutral (Yellow)
|
Survival at hospital admission
|
Patient
|
|
Sanfilippo F., Corredor C., Santonocito C., Panarello G., Arcadipane A., Ristagno G., et al. Amiodarone or lidocaine for cardiac arrest: A systematic review and meta-analysis. Resuscitation 2016; 107:31-7. Medline
|
II
|
Opposes (Red)
|
Amplitude Spectral Area of fibrillation
|
Process
|
PH-Paramedic
|
Gentile FR, Wik L, Aramendi E, Baldi E, Isasi I, et al. aMplitude spectral area of ventricular fibrillation and amiOdarone Study in patients with out-of-hospital cArdIaC arrest. The MOSAIC study. Front Cardiovasc Med 2023; 10:1179815 Medline
|
III
|
Supportive (Green)
|
Survival to hospital admission
|
Patient
|
PH-Paramedic
|
Ong ME., Pellis T., Link MS. The use of antiarrhythmic drugs for adult cardiac arrest: a systematic review. Resuscitation 2011; 82(6):665-70. Medline
|
III
|
Supportive (Green)
|
Hemodynamic side effects
|
Patient
|
PH-Paramedic
|
Skrifvars MB., Kuisma M., Boyd J., Maatta T., Repo J., Rosenberg PH., Castren M. The use of undiluted amiodarone in the mgt of out-of-hospital cardiac arrest. Acta Anaesth Scand 2004; 48:582-7. Medline
|
III
|
Supportive (Green)
|
Hemodynamic side effects
|
Patient
|
PH-Paramedic
|
Skrifvars MB., Kuisma M., Boyd J., Maatta T., Repo J., Rosenberg PH., Castren M. The use of undiluted amiodarone in the mgt of out-of-hospital cardiac arrest. Acta Anaesth Scand 2004; 48:582-7. Medline
|
III
|
Neutral (Yellow)
|
Survival to DC
|
Patient
|
PH-Paramedic
|
Olasveengen TM., Sunde K., Brunborg C., Thowsen J., Steen PA., Wik L. Intravenous drug administration during out-of-hospital cardiac arrest: A randomized trial. JAMA 2009; 302(20):2222-9. Medline
|
III
|
Neutral (Yellow)
|
Survival
|
Patient
|
ED-MD
|
Pollak PT., Wee V., Al-Hazmi A., Martin J., Zarnke KB. The use of amiodarone for in-hospital cardiac arrest at two tertiary care centres. Can J Cardiol 2006; 22(3):199-202. Medline
|
III
|
Neutral (Yellow)
|
ROSC
|
Process
|
PH-Paramedic
|
Yasuda S., Sawano H., Hazui H. Ukai I. et al. Report from J-PULSE Multicentre Registry of Patients With Shock-Resistant Out-of-Hospital Cardiac Arrest Treated with Nikekalant Hydrochloride. Japan Circ J 2010; 74(11):2308-13. Medline
|
Biphasic Defibrillation
Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
I
|
Supportive (Green)
|
Survival to discharge
|
Patient
|
PH-Paramedic
|
Auble TE., Menegazzi JJ., Paris PM. Effect of out-of-hospital defibrillation by basic life support providers on cardiac arrest mortality: a meta-analysis. Ann Emerg Med 1995; 25(5):642-8. Medline
|
I
|
Supportive (Green)
|
First-shock efficacy rates
|
Process
|
ED-MD
|
Bardy GH., Marchlinski FE., Sharma AD., et al. Multicenter comparison of truncated biphasic shocks and standard damped sine wave monophasic shocks for transthoracic ventricular defibrillation. Circulation 1996; 94(10):2507-14. Medline
|
I
|
Supportive (Green)
|
First Shock Success
|
Patient
|
OR
|
Higgins SL., Herre JM., Epstein AE., et al. A comparison of biphasic and monophasic shocks for external defibrillation. Physio-Control Biphasic Investigators. Prehosp Emerg Care 2000; 4(4):305-13. Medline
|
I
|
Supportive (Green)
|
Return of organized rhythm
|
Patient
|
PH-Paramedic
|
Koster RW., Walker RG., van Alem AP. Definition of successful defibrillation. Crit Care Med 2006; 34(12 Suppl):S423-6. Medline
|
I
|
Supportive (Green)
|
Survival to hospital
|
Patient
|
PH-Paramedic
|
Kudenchuk PJ., Cobb LA., Copass MK., Olsufka M., Maynard C., Nichol G. Transthoracic incremental monophasic versus biphasic defibrillation by emergency responders (TIMBER): A randomized comparison of monophasic with biphasic waveform ascending energy defibrillation for the resuscitation of out-of-hospital cardiac arrest due to ventricular fibrillation. Circulation 2006; 114(19):2010-8. Medline
|
I
|
Supportive (Green)
|
Defibrillation efficacy
|
Patient
|
PH-Paramedic
|
Martens P., Russell J., Wolcke B., Paschen H., Kuisma M., Gliner B., Weaver WD., Bossaert L., Chamberlain D., Schneider T. Optimal Response to Cardiac Arrest study: Defibrillation waveform effects. Resuscitation 2001; 49:233-43. Medline
|
I
|
Supportive (Green)
|
Conversion to organized rhythm at 5s after
|
Patient
|
PH-Paramedic
|
Morrison LJ., Dorian P., Long J., et al. Out-of-hospital cardiac arrest rectilinear biphasic to monophasic damped sine defibrillation waveforms with advanced life support intervention trial (ORBIT). Resuscitation 2005; 66(2):149-57. Medline
|
I
|
Supportive (Green)
|
Termination of (VF) and (VT)
|
Patient
|
PH-Paramedic
|
Morrison LJ., Henry RM., Ku V., Nolan JP., Morley P., Deakin CD. Single-shock defibrillation success in adult cardiac arrest: A systematic review. Resuscitation 2013; 84(11):1480-6. Medline
|
I
|
Supportive (Green)
|
Defibrillation efficacy
|
Patient
|
PH-Paramedic
|
Schneider T., Martens PR., Paschen H., et al. Multicenter, randomized, controlled trial of 150-J biphasic shocks compared with 200- to 360-J monophasic shocks in the resuscitation of out-of-hospital cardiac arrest victims. Optimized Response to Cardiac Srrest (ORCA) investigators. Circulation 2000; 102(15):1780-7. Medline
|
I
|
Supportive (Green)
|
Survival
|
Patient
|
PH-Paramedic
|
Watts DD. Defibrillation by basic emergency medical technicians: Effect on survival. Ann Emerg Med. 1995; 26(5):635-639. Medline
|
I
|
Neutral (Yellow)
|
Termination of VF, Return of organized rhythm post first shock, ROSC, Survival to DC.
|
Patient
|
PH-Paramedic
|
Wang CH., Huang CH., Chang WT., et al. Biphasic versus monophasic defibrillation in out-of-hospital cardiac arrest: A systematic review and meta-analysis. Am J Emerg Med 2013; 31(10):1472-1478. Medline
|
II
|
Supportive (Green)
|
ROSC
|
Process
|
PH-Paramedic
|
Freeman K., Hendey GW., Shalit M., Stroh G. Biphasic defibrillation does not improve outcomes compared to monophasic defibrillation in out-of-hospital cardiac arrest. Prehosp Emerg Care 2008; 12(2):152-6. Medline
|
II
|
Supportive (Green)
|
Neurologically favorable 30 day survival
|
Patient
|
PH-Paramedic
|
Kajino K., Iwami T., Berg RA., et al. Comparison of neurological outcomes following witnessed out-of-hospital ventricular fibrillation defibrillated with either biphasic or monophasic automated external defibrillators. Emerg Med J 2009; 26(7):492-6. Medline
|
II
|
Supportive (Green)
|
ROSC
|
Patient
|
PH-Paramedic
|
Meilandt C, Qvortrup M, Bøtker MT, et al. Association Between Defibrillation Using LIFEPAK 15 or ZOLL X Series and Survival Outcomes in Out-of-Hospital Cardiac Arrest: A Nationwide Cohort Study. J Am Hear Assoc. March 2024; 13(7):e033913. Medline
|
II
|
Supportive (Green)
|
Survival to hospital discharge.
|
Patient
|
PH-Paramedic
|
Nichol G., Stiell IG., Laupacis A., Pham B., De Maio VJ., Wells GA. A cumulative meta-analysis of the effectiveness of defibrillator-capable emergency medical services for victims of out-of-hospital cardiac arrest. Ann Emerg Med 1999; 34(4 Pt 1):517-25. Medline
|
II
|
Supportive (Green)
|
Termination of VF.
|
Patient
|
PH-Paramedic
|
Stothert JC., Hatcher TS., Gupton CL., Love JE., Brewer JE. Rectilinear biphasic waveform defibrillation of out-of-hospital cardiac arrest. Prehosp Emerg Care 2004; 8(4):388-392. Medline
|
II
|
Supportive (Green)
|
Survival at 1 month
|
Patient
|
PH-Paramedic
|
Tanabe S., Yasunaga H., Ogawa T., et al. Comparison of outcomes after use of biphasic or monophasic defibrillators among out-of-hospital cardiac arrest patients: A nationwide population-based observational study. Circ Cardiovasc Qual Outcomes 2012; 5(5):689-696. Medline
|
II
|
Neutral (Yellow)
|
Optimal first shock energy for biphasic defibrillation
|
Process
|
PH-Paramedic & MD
|
Pocock H, Deakin CD, Lall R, Smith CM, Perkins GD. Effectiveness of alternative shock strategies for out-of-hospital cardiac arrest: A systematic review. Resusc Plus 2022; 10:100232. Medline
|
II
|
Neutral (Yellow)
|
Survival to hospital discharge
|
Patient
|
PH-Paramedic
|
Sweeney TA., Runge JW., Gibbs MA., et al. EMT defibrillation does not increase survival from sudden cardiac death in a two-tiered urban-suburban EMS system. Ann Emerg Med 1998; 31(2):234-240. Medline
|
III
|
Supportive (Green)
|
Percent efficacy
|
Process
|
OR
|
Bardy GH., Gliner BE., Kudenchuk PJ., et al. Truncated biphasic pulses for transthoracic defibrillation. Circulation 1995; 91(6):1768-74. Medline
|
III
|
Supportive (Green)
|
Detection ventricular vf/vt-pulseless (shock advised)
|
Process
|
SIM
|
Leng CT., Paradis NA., Calkins H., et al. Resuscitation after prolonged ventricular fibrillation with use of monophasic and biphasic waveform pulses for external defibrillation. Circulation 2000; 101(25):2968-74. Medline
|
III
|
Supportive (Green)
|
Delayed onset of asystole/PEA
|
Patient
|
|
Scheatzle MD., Menegazzi JJ., Allen TL., et al. Evaluation of biphasic transthoracic defibrillation in an animal model of prolonged ventricular fibrillation. Acad Emerg Med 1999; 6(9):880-6. Medline
|
III
|
Supportive (Green)
|
Successful defibrillation
|
Patient
|
OR
|
Szili-Torok T., Theuns D., Verblaauw T., et al. Transthoracic defibrillation of short-lasting ventricular fibrillation: A randomised trial for comparison of the efficacy of low-energy biphasic rectilinear and monophasic damped sine shocks. Acta Cardiol 2002; 57(5):329-334. Medline
|
III
|
Supportive (Green)
|
Survival to Discharge
|
Patient
|
PH-Paramedic
|
White RD., Asplin BR., Bugliosi TF., Hankins DG. High discharge survival rate after out-of-hospital ventricular fibrillation with rapid defibrillation by police and paramedics. Ann Emerg Med 1996; 28(5):480-485. Medline
|
CPR before defibrillation
Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
I
|
Neutral (Yellow)
|
Time to intubation
|
Process
|
SIM
|
Baker P., Conway J., Cotton C., Ashby D., Smyth J., Woodman J., Grantham H. Defibrillation versus Cardiopulmonary Resuscitation first for patients with Out-Of-Hospital Cardiac Arrests found by Paramedics to be in Ventricular Fibrillation. Resus 2008; 79:424-31. Medline
|
I
|
Neutral (Yellow)
|
Survival to discharge
|
Patient
|
PH-Paramedic
|
Freese JP., Jorgenson DB., Liu PY., et al. Waveform analysis-guided treatment versus a standard shock-first protocol for the treatment of out-of-hospital cardiac arrest presenting in ventricular fibrillation: Results of an international randomized, controlled trial. Circulation 2013; 128(9):995-1002. Medline
|
I
|
Neutral (Yellow)
|
Survival to hospital d/c
|
Patient
|
PH-Paramedic
|
Jacobs IG., Finn JC., Oxer HF., Jelinek GA. CPR before defibrillation in OOHCA: an RCT. Emerg Med Australas 2005; 17(1):39-45. Medline
|
I
|
Neutral (Yellow)
|
Survival to hospital admission
|
Patient
|
PH-Paramedic
|
Jost D., Degrange H., Verret C., Hersan O., et al. DEFI 2005: A randomized controlled trial of the effect of automated external defibrillator cardiopulmonary resuscitation protocol on outcome from out-of-hospital cardiac arrest. Circ 2010; 121(14)1614-22. Medline
|
I
|
Neutral (Yellow)
|
Sustained ROSC
|
Patient
|
PH-Paramedic
|
Ma MH., Chiang WC., Ko PC., et al. A randomized trial of compression first or analyze first strategies in patients with out-of-hospital cardiac arrest: Results from an asian community. Resuscitation 2012; 83(7):806-12. Medline
|
I
|
Neutral (Yellow)
|
Survival
|
Patient
|
PH-Paramedic
|
Meier P., et al. Chest Compressions before Defibrillation for Out-of-Hospital Cardiac Arrest: A meta-Analysis of Randomized Controlled Trials. BMC 2010; 8:52-65. Medline
|
I
|
Neutral (Yellow)
|
survival to hospital discharge
|
Patient
|
PH-Paramedic
|
Simpson P., et al. Delayed Versus Immediate Defibrillation for Out-of-Hospital Cardiac Arrest due to Ventricular Fibrillation: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Resus 2010; 81:925-931. Medline
|
I
|
Neutral (Yellow)
|
Survival to discharge with satisfactory functional status
|
Patient
|
PH-Paramedic
|
Stiell IG., Nichol G., Leroux BG., et al. Early versus later rhythm analysis in patients with out-of-hospital cardiac arrest. N Engl J Med 2011; 365(9):787-797. Medline
|
I
|
Neutral (Yellow)
|
Survival to discharge
|
Patient
|
PH-Paramedic
|
Wik L., Hansen T., Fylling F., Steen T., Vaagenes P., Auestad B., Steen P. Delaying Defibrillation to Give Basic Cardiopulmonary Resuscitation to Patients With Out-of-hospital Ventricular Fibrillation A Randomized Trail. JAMA 2003; 289(11):1389-1395. Medline
|
II
|
Supportive (Green)
|
Survival and neurologic status at hospital discharge
|
Patient
|
PH-Paramedic
|
Cobb LA., Fahrenbruch CE., Walsh TR., et al. Influence of CPR prior to defibrillation in patients with OOH VF. JAMA 1999; 281:1182-8. Medline
|
II
|
Supportive (Green)
|
One- month survival
|
Patient
|
PH-Paramedic
|
Koike S., Tanabe S., Ogawa T., et al. Immediate defibrillation or defibrillation after cardiopulmonary resuscitation. Prehosp Emerg Care 2011; 15(3):393-400. Medline
|
II
|
Neutral (Yellow)
|
Defibrillation success
|
Process
|
PH-Paramedic
|
Eftestol T., Wik L., Sunde K., Steen PA. Effects of CPR on predictors of VF defibrillation during OOHCA. Circulation 2004; 110:10-5. Medline
|
Defibrillation
Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
I
|
Supportive (Green)
|
Survival to discharge
|
Patient
|
PH-Paramedic
|
Eisenberg MS., Hallstrom AP., Copass MK., Bergner L., Short F., Pierce J. Treatment of ventricular fibrillation. Emergency medical technician defibrillation and paramedic services. JAMA 1984; 251(13):1723-6. Medline
|
I
|
Supportive (Green)
|
Ventricular fibrillation conversion
|
Patient
|
PH-Paramedic
|
Stiell IG., et al. A randomized comparison of fixed lower vs escalating higher energy levels for defibrillation in OOHCA. Circulation 2007; 115:1511-7. Medline
|
II
|
Supportive (Green)
|
Good neurological recovery
|
Patient
|
PH-Paramedic
|
Lee SGW, Park JH, Ro YS, Hong KJ, Song KJ, Shin SD. Time to first defibrillation and survival outcomes of out-of-hospital cardiac arrest with refractory ventricular fibrillation. Am J Emerg Med 2021; 40:96-102. Medline
|
II
|
Supportive (Green)
|
Survival to hospital discharge
|
Patient
|
|
Nehme Z., Andrew E., Nair R., Bernard S., Smith K. Manual Versus Semiautomatic Rhythm Analysis and Defibrillation for Out-of-Hospital Cardiac Arrest. Circulation Cardiovascular Quality and Outcomes 2017; 10(7). Medline
|
II
|
Supportive (Green)
|
Survival to hospital discharge
|
Patient
|
PH-Paramedic
|
Stiell IG., Wells GA., Field BJ., et al. Improved out-of-hospital cardiac arrest survival through the inexpensive optimization of an existing defibrillation program: OPALS study phase II. Ontario prehospital advanced life support. JAMA 1999; 281(13):1175-1181. Medline
|
II
|
Supportive (Green)
|
Quality of life
|
Patient
|
PH-Paramedic
|
van Alem AP., Waalewijn RA., Koster RW., de Vos R. Assessment of quality of life and cognitive function after out-of-hospital cardiac arrest with successful resuscitation. Am J Cardiol 2004; 93(2):131-135. Medline
|
II
|
Neutral (Yellow)
|
Survival to 1 month post discharge
|
Patient
|
PH-Paramedic
|
Sekimoto M., Rahman M., Noguchi Y., Hira K., Shimbo T., Fukui T. The defibrillation system of basic emergency medical technicians in japan: A comparison with other systems from a 14-year review of out-of-hospital cardiac arrest reports. J Epidemiol 2001; 11(1):29-40. Medline
|
III
|
Supportive (Green)
|
Interval to first shock
|
Process
|
SIM
|
Verbeek PR., Turner D., Lane CJ., Carter CC. A comparison of two automated external defibrillator algorithms. Acad Emerg Med 1999; 6(6):631-6. Medline
|
III
|
Neutral (Yellow)
|
Detection pinion vf/vt-pulseless (shock advised)
|
Process
|
|
Nolan JP., Soar J. Defibrillation in clinical practice. Curr Opinion Crit Care 2009; 15:1070. Medline
|
III
|
Neutral (Yellow)
|
Survival time
|
Patient
|
PH-Paramedic
|
Wang HE., Min A., Hostler D., Chang CC., Callaway CW. Differential effects of out-of-hospital interventions on short- and long-term survival after cardiopulmonary arrest. Resuscitation 2005; 67(1):69-74. Medline
|
III
|
Neutral (Yellow)
|
Difference in mean transthoracic impedance
|
Patient
|
PH-Paramedic
|
White RD., Blackwell TH., Russell JK., Snyder DE., Jorgenson DB. Transthoracic impedance does not affect defibrillation... Resus 2005; 64:63-9. Medline
|
Double Sequential Defibrillation
Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
I
|
Neutral (Yellow)
|
Survival
|
Patient
|
ED-Paramedic & MD
|
Miraglia D, Miguel LA, Alonso W. Double Defibrillation for Refractory In- and Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis. J of Emerg Med (0736-4679) 2020; 59(4):521-41. Medline
|
II
|
Supportive (Green)
|
Survival to discharge
|
Patient
|
Other
|
Abuelazm MT, Ghanem A, Katamesh BE, Hassan AR, et al. Defibrillation strategies for refractory ventricular fibrillation out-of-hospital cardiac arrest: A systematic review and network meta-analysis. Ann Noninvasive Electrocardiol July 2023; e13075. Medline
|
II
|
Supportive (Green)
|
Survivial to hospital discharge
|
Patient
|
PH-Paramedic
|
Cheskes S, Verbeek PR, Drennan IR, McLeod SL, Turner L, et al. Defibrillation Strategies for Refractory Ventricular Fibrillation. N Engl J Med Nov 2022; 387(21):1947–56. Medline
|
II
|
Supportive (Green)
|
ROSC
|
Patient
|
|
Emmerson AC., Whitbread M., Fothergill RT. Double sequential defibrillation therapy for out-of-hospital cardiac arrests: The London experience. Resuscitation 2017; 117:97-101. Medline
|
II
|
Supportive (Green)
|
Termination of VF
|
Patient
|
PH-Paramedic
|
Rahimi M, Drennan IR, Turner L, Dorian P, Cheskes S. The impact of double sequential shock timing on outcomes during refractory out-of-hospital cardiac arrest. Resuscitation 2023; 194:110082. Medline
|
II
|
Supportive (Green)
|
Neurologically intact survival to hospital discharge.
|
Patient
|
|
Ross EM., Redman TT., Harper SA., Mapp JG., Wampler DA., Miramontes DA. Dual defibrillation in out-of-hospital cardiac arrest: A retrospective cohort analysis. Resuscitation 2016; 106:14-7. Medline
|
II
|
Neutral (Yellow)
|
Termination of VF
|
Process
|
PH-Paramedic
|
Cheskes S., Wudwud A., Turner L., McLeod S., Summers J., Morrison LJ., et al. The impact of double sequential external defibrillation on termination of refractory ventricular fibrillation during out-of-hospital cardiac arrest. Resuscitation 2019; 139:275-81. Medline
|
II
|
Neutral (Yellow)
|
Termination of RVF
|
Patient
|
|
Li Y, He X, Li Z, Li D, Yuan X, Yang J. Double sequential external defibrillation versus standard defibrillation in refractory ventricular fibrillation: A systematic review and meta-analysis. Front Cardiovasc Med Nov 2022; 9:1017935. Medline
|
II
|
Neutral (Yellow)
|
Survival to hospital admission
|
Patient
|
|
Mapp JG, Hans AJ, Darrington AM, Ross EM, Ho CC. Prehospital Double Sequential Defibrillation: A Matched Case-Control Study. Acad Emerg Med. 2018. [Epub ahead of print] Medline
|
III
|
Supportive (Green)
|
ROSC
|
Patient
|
PH-Paramedic
|
Choi HJ, Noh H. Successful defibrillation using double sequence defibrillation: Case reports. Medicine (Baltimore) 2021; 100(10):e24992. Medline
|
III
|
Supportive (Green)
|
Survival neurologically intact
|
Patient
|
|
El Tawil C., Mrad S., Khishfe BF. Double sequential defibrillation for refractory ventricular fibrillation. Am J Emerg Med 2017; 35(12):1985.e3-4. Medline
|
III
|
Supportive (Green)
|
-
|
Patient
|
|
Johnston M., Cheskes S., Ross G., Verbeek PR.. Double Sequential External Defibrillation and Survival from Out-of-Hospital Cardiac Arrest: A Case Report. Prehosp Emerg Care 2016; 20(5):662-6. Medline
|
III
|
Supportive (Green)
|
ROSC
|
Patient
|
|
Lybeck AM., Moy HP., Tan DK. Double Sequential Defibrillation for Refractory Ventricular Fibrillation: A Case Report. Prehosp Emerg Care 2015; 19(4):554-7. Medline
|
III
|
Supportive (Green)
|
Conversion
|
Patient
|
|
Merlin MA., Tagore A., Bauter R., Arshad FH. A Case Series of Double Sequence Defibrillation. Prehosp Emerg Care 2016; 20(4):550-3. Medline
|
III
|
Neutral (Yellow)
|
Termination of shock-resistant VF
|
Patient
|
|
Bell CR., Szulewski A., Brooks SC. Make it two: A case report of dual sequential external defibrillation. CJEM 2017:1-6. Medline
|
III
|
Neutral (Yellow)
|
Termination of refractory VF
|
Patient
|
|
Cabanas JG., Myers JB., Williams JG., De Maio VJ., Bachman MW. Double Sequential External Defibrillation in Out-of-Hospital Refractory Ventricular Fibrillation: A Report of Ten Cases. Prehosp Emerg Care 2015; 19(1):126-30. Medline
|
III
|
Neutral (Yellow)
|
ROSC
|
Patient
|
|
Cortez E., Krebs W., Davis J., Keseg DP., Panchal AR. Use of double sequential external defibrillation for refractory ventricular fibrillation during out-of-hospital cardiac arrest. Resuscitation 2016; 108:82-6. Medline
|
III
|
Neutral (Yellow)
|
ROSC
|
Patient
|
PH-Paramedic & MD
|
Katzenschlager S, Heck R, Popp E, et al. Out-of-hospital cardiac arrest treated with prehospital double sequential external defibrillation during eCPR in refractory VF - a case report. Int J Emerg Med October 2023; 16(1):71. Medline
|
III
|
Neutral (Yellow)
|
Survival to discharge
|
Patient
|
PH-Paramedic
|
Miraglia D, Alonso W. A review of pre-hospital case series among those with time to double external defibrillation and neurologic outcomes. Am J Emerg Med 2020. Medline
|
X
|
Not Yet Graded (White)
|
-
|
|
|
Nordviste V, Rehn M, Krüger AJ, Brede JR. Time difference between pad placement in single versus double external defibrillation: A live patient simulation model. Resusc Plus Aug 2024; 19:100741. Medline
|