Survival of resuscitated cardiac arrest patients with ST-elevation myocardial infarction (STEMI) conveyed directly to a Heart Attack Centre by ambulance clinicians

Resuscitation. 2014 Jan;85(1):96-8. doi: 10.1016/j.resuscitation.2013.09.010. Epub 2013 Sep 19.

Abstract

Objective: This study reports survival outcomes for patients resuscitated from out-of-hospital cardiac arrest (OHCA) subsequent to ST-elevation myocardial infarction (STEMI), and who were conveyed directly by ambulance clinicians to a specialist Heart Attack Centre for expert cardiology assessment, angiography and possible percutaneous coronary intervention (PCI).

Methods: This is a retrospective descriptive review of data sourced from the London Ambulance Service's OHCA registry over a one-year period.

Results: We observed excellent survival rates for our cohort of patients with 66% of patients surviving to be discharged from hospital, the majority of whom were still alive after one year. Those who survived tended to be younger, to have had a witnessed arrest in a public place with an initial cardiac rhythm of VF/VT, and to have been transported to the specialist centre more quickly than those who did not.

Conclusion: A system allowing ambulance clinicians to autonomously convey OHCA STEMI patients who achieve a return of spontaneous circulation directly to a Heart Attack Centre is highly effective and yields excellent survival outcomes.

Keywords: Ambulance; Heart Attack Centre; Out-of-hospital cardiac arrest; PCI; ST-elevation myocardial infarction; STEMI.

MeSH terms

  • Ambulances
  • Cardiac Care Facilities
  • Cardiopulmonary Resuscitation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / complications
  • Myocardial Infarction / physiopathology
  • Out-of-Hospital Cardiac Arrest / etiology
  • Out-of-Hospital Cardiac Arrest / mortality*
  • Out-of-Hospital Cardiac Arrest / therapy*
  • Retrospective Studies
  • Survival Rate