P260 INCIDENCE, CHARACTERISTICS, AND OUTCOMES OF OUT–OF–HOSPITAL CARDIAC ARREST DUE TO VENTRICULAR FIBRILLATION IN THE GENERAL POPULATION: DATA FROM A SINGLE–CENTER LONG–TERM REGISTRY

Abstract

Abstract Out–of–hospital cardiac arrest (OHCA) is a major public health problem, and ventricular fibrillation (VF) is the most frequently encountered initial rhythm when cardiac disease is the cause of the arrest. It can be treated with successful defibrillation, if prompt intervention, otherwise it rapidly progresses to non–shockable rhythms, with survival rates ranging from 3 to 10%. The early defibrillation strategy led to a significant improvement in outcome; although Automated External Defibrillators (AEDs) are still used in <3% of OHCAs. All consecutive OHCAs registered in Piacenza from January 2013 to June 2022 in which CPR was initiated were analysed. "Progetto Vita", the first European early defibrillation project, was born in Piacenza in 1999, with the aim of improving the diffusion of AEDs in public places, sports centres, workplaces and homes, in order to allow timely treatment of the OHCA by non–medical personnel (citizens, police…) awaiting the arrival of advanced emergency services (EMS). During the review period, 3,124 patients were treated for OHCA; 323 had VF; VF occurred predominantly at home (73%), in men (75%); the mean age was 70 years. CPR by lay citizens was performed in 35 cases (11%) with a survival rate of 63%. AED used by lay or police was used in 30 cases (9%) with a survival rate of 77%. Cardiac comorbidities were observed in 67 patients (21%), predominantly male, with CAD being the most common disease. The main characteristics are listed in Table 1. There were 237 deaths (73% fatality rate), 41 (17%) recorded after EMS arrival. Among hospitalized patients, VF was related to coronary artery disease (70%) and STEMI was the most frequent manifestation. Overall, 87 (27%) patients survived and were hospitalized. Multivariate logistic regression analysis showed that layman CPR (OR 2.52, 95% CI 1.04, 6.1, p=0.04) and AED use (OR 7.15; 95% CI 2.66, 19.19, p<0.001) were both independent predictors of survival. VF in the general population is still poorly predictable and mortality remains high: the implementation of the diffusion of public AEDs seems effective in improving survival.