Abstract
Although antiarrhythmic drugs have long been used for the suppression of various types of arrhythmias, their prior use before the onset of ventricular arrhythmia with hemodynamic collapse and the effect on prognosis is not well known. Data from 1004 consecutive patients with cardiovascular shock in the Japanese Circulation Society’s Shock Registry were analyzed. Eighty-four cases of ventricular arrhythmia-induced shock and ROSC (return of spontaneous circulation) were divided into the prior amiodarone or β-blockers use group (Aβ group, n = 27) and the non-amiodarone and non-β-blockers use group (non-Aβ group; n = 57) based on treatment before the onset of those arrhythmias. Clinical outcomes related to hemodynamic collapse such as OHCA (out-of-hospital cardiovascular arrest) was less in the Aβ group [Aβ group, 11/26 (42%) vs. non-Aβ group, 41/56 (73%); p = 0.007]. Similarly, syncope was less common in the Aβ group than in the non-Aβ group [Aβ group 4/27 (15%) vs. non-Aβ group 27/57 (47%); p = 0.004]. Furthermore, prior amiodarone or β-blockers use before the onset of ventricular arrhythmias was strongly associated with both survival at discharge (odds ratio 3.19; 95% confidence interval 1.06–9.67; p = 0.040) and neurological outcomes at discharge (odds ratio 3.96; 95% confidence interval 1.32–11.85; p = 0.014) based on multivariate logistic regression analysis. Prior amiodarone or β-blockers use before the onset of malignant ventricular arrhythmia and maintaining appropriate blood concentrations in advance is associated with a good survival rate and better neurological outcomes after recovery from ventricular arrhythmia with hemodynamic collapse.
Similar content being viewed by others
References
The CAST Investigators (1989) Effect of encainide and flecainide on mortality in randomized trial of arrhythmia suppression after myocardial infarction. N Engl J Med 321:406–412
The CAST-II Investigators (1992) Effect of the antiarrhythmic agent moricizine on survival after myocardial infarction. N Engl J Med 327:227–233
Vaughan Williams EM (1975) Classification of antiarrhythmic drugs. Pharmacol Ther B 1(1):115–138
Task Force of the Working Group on Arrhythmias of the European Society of Cardiology (1991) The Sicilian Gambit. A new approach to the classification of antiarrhythmic drugs based on their actions on arrhythmogenic mechanisms. Circulation 84(4):1831–1851
Kodama I, Ogawa S, Inoue H, Kasanuki H, Kato T, Mitamura H, Hiraoka M, Sugimoto T (1999) Profiles of aprindine, cibenzoline, pilsicainide, and pirmenol in framework of the Sicilian Gambit. Jpn Circ J 63:1–12
Cairns JA, Connolly SJ, Roberts R, Gent M, Canadian Amiodarone Myocardial Infarction Arrhythmial Trial Investigators (1997) Randomised trial of outcome after myocardial infarction in patients with frequent or repetitive ventricular premature depolarisations: CAMIAT. Lancet 349:675–682
Singh SN, Fletcher RD, Fisher SG, Singh BN, Lewis HD, Deedwania PC, Massie BM, Colling C, Lazzeri D, Survival trial of antiarrhythmig therapy in congestive heart failure (1995) Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia. N Engl J Med 333:77–82
Schupp T, Behnes M, Reiser L, Bollow A, Taton G, Reichelt T, Ellguth D, Engelke N, Ansari U, El-Battrawy I, Bertsch T, WeiB C, Nienaber C, Lang S, Akin M, Mashayekhi K, Borggrefe M, Akin I (2019) Prognostic impact of beta-blocker compared to combined amiodarone therapy secondary to ventricular tachyarrhythmias. Int J Cardiol 277:118–124
Singh SN, Fletcher RD, Fisher SG, Singh BN, Lewis DH, Deedwania PC, Massie BM, Colling C, Lazzeri D (1995) Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia. Survival trial of antiarrhythmic therapy in congestive heart failure. N Engl J Med 333:77–82
Kasanuki H, Inaba T, Ohnisi S, Shoda M, Matsuda N, Hosoda S (1994) Long term results of amiodarone therapy in patients with sustained ventricular tachycardia or ventricular fibrillation for prevention of cardiac sudden death. Jpn Circ J 58:1309–1312
Strasburger JF, Cuneo BF, Michon MM, Gotteiner NL, Deal BJ, McGregor SN, Oudijk MA, Meijiboom EJ, Feinkind L, Hussey M, Parilla BV (2004) Amiodarone therapy for drug refractory fatal tachycardia. Circulation 109:375–379
Ji XF, Li CS, Wang S, Yang L, Cong LH (2010) Comparison of the efficacy of nifekalant and amiodarone in a porcine model of cardiac arrest. Resuscitation 81:1031–1036
The CASCADE Investigators (1993) Randomized antiarrhythmic drug therapy in survivors of cardiac arrest. Am J Cardiol 72(3):280–287
Nora M, Zipes DP (1993) Empiric use of amiodarone and sotacol. Am J Cardiol 72(16):62F-69F
Laina A, Karlis G, Liakos A, Georgiopoulos G, Oikonomou D, Kouskouni E, Chalkias A, Xanthos T (2016) Amiodarone and cardiac arrest: systematic review and meta-analysis. Int J Cardiol 221:780–788
Dorian P, Cass D, Scwartz B, Cooper R, Gelaznikas R, Barr A (2002) Amiodarone as compared with lidocaine for shock-resistant ventricular fibrillation. N Engl J Med 346:884–890
Kudenchuk PJ, Cobb LA, Copass MK, Cummins RO, Doherty AM, Fahrenbruch CE, Hallstrom AP, Murray WA, Olsufka M, Walsh T (1999) Amiodarone for resuscitation after out-of-hospital cardiac arrest due to ventricular fibrillation. N Engl J Med 341:871–878
Pasupula DK, Bhat A, Siddappa Malleshappa SK, Munir MB, Barakat A, Jain S, Wang NC, Saba S, Bhonsale A (2020) Impact of change in 2010 american heart association cardiopulmonary resuscitation guidelines on survival after out-of-hospital cardiac arrest in the United States: an analysis from 2006 to 2015. Circ Arrhythm Electrophysiol 13:e007843
Valenzuela TD, Roe DJ, Cretin S, Spaite DW, Larsen MP (1997) Estimating effectiveness of cardiac arrest interventions: a logistic regression survival model. Circulation 96:3308–3313
Nakashima T, Noguchi T, Tahara Y, Nishimura K, Yasuda S, Onozuka D, Iwami T, Yonemoto N, Nagao K, Nonogi H, Ikeda T, Sato N, Tsutsui H (2019) Public-access defibrillation and neurological outcomes in patients with out-of-hospital cardiac arrest in Japan: a population-based cohort study. Lancet 394:2255–2262
Aufderheide TP, Pirrallo RG, Yannopoulos D, Klein CB, Sparks CW, Deja KA, Kitscha DJ, Provo TA, Lurie KG (2006) Incomplete chest wall decompression: a clinical evaluation of CPR performance by trained laypersons and an assessment of alternative manual chest compression-decompression techniques. Resuscitation 71:341–351
Ueki Y, Mohri M, Matoba T, Tsujita Y, Yamasaki M, Tachibana E, Yonemoto N, Nagao K (2016) Characteristics and predictors of mortality in patients with cardiovascular shock in Japan—results from the Japanese Circulation Society Cardiovascular Shock Registry. Circ J 80(4):852–859
Brain Resuscitation Clinical Trial I Study Group (1986) Randomized clinical study of thiopental loading in comatose survivors of cardiac arrest. N Engl J Med 314:397–403
Jennett B, Bond M (1975) Assessment of outcome after severe brain damage. Lancet 1:480–484
Sanfilippo F, Corredor C, Santonocito C, Panarello G, Arcadipane A, Ristagno G, Pellis T (2016) Amiodarone or lidocaine for cardiac arrest: a systematic review and meta-analysis. Resuscitation 107:31–37
Bartlett ES, Valenzuela T, Idris A, Deye N, Glover G, Gillies MA, Taccone FS, Sunde K, Flint AC, Thiele H, Arrich J, Hemphill C, Holzer M, Skrifvars MB, Pittl U, Polderman KH, Ong MEH, Kim KH, Oh SH, Shin SD, Kirkegaard H, Nichol G (2020) Systematic review and meta-analysis of intravascular temperature management vs. surface cooling in comatose patients resuscitated from cardiac arrest. Resuscitation 146:82–95
Kimura H, Kawahara K, Yamauchi Y, Miyaki J (2005) On the mechanisms for the conversion of ventricular fibrillation to tachycardia by perfusion with ruthenium red. J Electrocardiol 38:364–370
Kawahara K, Takase M, Yamauchi Y, Kimura H (2004) Spectral and correlation analyses of the verapamil-induced conversion of ventricular fibrillation to tachycardia in isolated rat hearts. J Electrocardiol 37:89–100
Samie FH, Jalife J (2001) Mechanisms underlying ventricular tachycardia and its transition to ventricular fibrillation in the structurally normal heart. Cardiovasc Res 50:242–250
Galatianou I, Karlis G, Apostolopoulos A, Intas G, Chalari E, Gulati A, Iacovidou N, Chalkias A, Xanthos T (2017) Body mass index and outcome of out-of-hospital cardiac arrest patients not treated by targeted temperature management. Am J Emerg Med 35:1247–1251
Fukuchi H, Nakashima M, Araki R, Komiya N, Hayano M, Yano K, Sasaki H, Yukawa E (2009) Effect of obesity on serum amiodarone concentration in Japanese patients: population pharmacokinetic investigation by multiple trough screen analysis. J Clin Pharm Ther 34:329–336
Yamanashi Y (2019) Translational research based on understanding the regulatory mechanisms of in vivo behaviors of fat-soluble compounds. Yakugaku Zasshi 139:1485–1494
Umehara T, Katayama N, Tsunematsu M, Kakehashi M (2020) Factors affecting hospital readmission heart failure patients in Japan: a multicenter retrospective cohort study. Heart Vessels 35:367–375
Kono Y, Izawa H, Aoyagi Y, Ishikawa A, Sugiura T, Mori E, Yanohara R, Ishiguro T, Yamada R, Okumura S, Fujiwara W, Hayashi M, Saitoh E (2020) Predictive impact of early mobilization on rehospitalization for elderly Japanese heart failure patients. Heart Vessel 35:531–536
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Yoshie, K., Yamasaki, M., Yokoyama, M. et al. Prognostic benefits of prior amiodarone or β-blocker use before the onset of ventricular arrhythmia with hemodynamic collapse. Heart Vessels 36, 1430–1437 (2021). https://doi.org/10.1007/s00380-021-01821-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00380-021-01821-2