Display options
Cite
Kauppila JP, Hantula A, Pakanen L, et al. Association of non-shockable initial rhythm and psychotropic medication in sudden cardiac arrest. Int J Cardiol Heart Vasc. 2020;28:100518doi: 10.1016/j.ijcha.2020.100518.
Kauppila, J. P., Hantula, A., Pakanen, L., Perkiömäki, J. S., Martikainen, M., Huikuri, H. V., & Junttila, M. J. (2020). Association of non-shockable initial rhythm and psychotropic medication in sudden cardiac arrest. International journal of cardiology. Heart & vasculature, 28100518. https://doi.org/10.1016/j.ijcha.2020.100518
Kauppila, Janna P, et al. "Association of non-shockable initial rhythm and psychotropic medication in sudden cardiac arrest." International journal of cardiology. Heart & vasculature vol. 28 (2020): 100518. doi: https://doi.org/10.1016/j.ijcha.2020.100518
Kauppila JP, Hantula A, Pakanen L, Perkiömäki JS, Martikainen M, Huikuri HV, Junttila MJ. Association of non-shockable initial rhythm and psychotropic medication in sudden cardiac arrest. Int J Cardiol Heart Vasc. 2020 Apr 22;28:100518. doi: 10.1016/j.ijcha.2020.100518. eCollection 2020 Jun. PMID: 32346603; PMCID: PMC7182673.
Copy Download .nbib Format: NLM
Share it on

Int J Cardiol Heart Vasc. 2020 Apr 22;28:100518. doi: 10.1016/j.ijcha.2020.100518. eCollection 2020 Jun.

Association of non-shockable initial rhythm and psychotropic medication in sudden cardiac arrest.

International journal of cardiology. Heart & vasculature

Janna P Kauppila, Antti Hantula, Lasse Pakanen, Juha S Perkiömäki, Matti Martikainen, Heikki V Huikuri, M Juhani Junttila

Affiliations

  1. Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland.
  2. Forensic Medicine Unit, National Institute for Health and Welfare, and Department of Forensic Medicine, Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu, Oulu, Finland.
  3. Center for Pre-hospital Emergency Care, Oulu University Hospital, Oulu, Finland.

PMID: 32346603 PMCID: PMC7182673 DOI: 10.1016/j.ijcha.2020.100518

Abstract

BACKGROUND: Asystole (ASY) and pulseless electrical activity (PEA) have a poor outcome during sudden cardiac arrest (SCA). Psychotropic medication has been associated with a risk for sudden cardiac death (SCD). Our aim was to study the association of psychotropic medication with ASY/PEA during SCA.

METHODS AND RESULTS: A total of 659 SCA subjects were derived from the emergency data of Oulu University Hospital (2007-2012). Subjects with non-cardiac origin of SCA and over 30-minute delay to rhythm recording were excluded. Population included 222 subjects after exclusions (mean age 64 ± 14 years, 78% males). Initial rhythm was ventricular fibrillation (VF) or ventricular tachycardia (VT) in 123 (55%), ASY in 67 (30%) and PEA in 32 (14%) subjects. The delay (collapse to rhythm recording) was similar in VF/VT and ASY/PEA subjects (median 8 min [1st-3rd quartile 3-12 min] versus 10 [0-14] minutes, p = 0.780). Among VF/VT subjects underlying cardiac disease was more often ischemic compared to ASY/PEA subjects (85% versus 68%, p = 0.003). Psychotropic medication was associated with ASY/PEA rhythm (OR 3.18, 95%CI 1.40-7.23, p = 0.006) after adjustment for gender, age and underlying cardiac disease. Subsequently, antipsychotics (OR 4.27, 95%CI 1.28-14.25, p = 0.018) were more common in the ASY/PEA group. Benzodiazepines and antidepressants were not associated with ASY/PEA.

CONCLUSION: Psychotropic medication and especially antipsychotics are associated with non-shockable rhythm during SCA and may lower the possibility of survival from the event. This might partly explain the risk of SCD related to psychotropic medication.

© 2020 The Authors.

Keywords: Asystole; Medico-legal autopsy; Psychotropic medication; Pulseless electrical activity; Sudden cardiac arrest

Conflict of interest statement

None.

References

  1. Resuscitation. 2000 Mar;44(1):7-17 - PubMed
  2. Eur Heart J. 2012 Mar;33(6):745-51 - PubMed
  3. Resuscitation. 2018 Dec;133:147-152 - PubMed
  4. Resuscitation. 2004 Dec;63(3):233-49 - PubMed
  5. Int J Geriatr Psychiatry. 2012 Nov;27(11):1131-7 - PubMed
  6. Circulation. 2006 Oct 3;114(14):1462-7 - PubMed
  7. Int J Cardiol. 2017 Jun 15;237:2-5 - PubMed
  8. R I Med J (2013). 2013 Mar 01;96(3):38-41 - PubMed
  9. Heart Rhythm. 2013 Apr;10(4):526-30 - PubMed
  10. N Engl J Med. 2009 Jan 15;360(3):225-35 - PubMed
  11. Resuscitation. 2014 Nov;85(11):1633-9 - PubMed
  12. Resuscitation. 2018 Jan;122:76-78 - PubMed
  13. Arch Gen Psychiatry. 2001 Dec;58(12):1161-7 - PubMed
  14. Heart Rhythm. 2011 Oct;8(10):1570-5 - PubMed
  15. Resuscitation. 2012 Aug;83(8):1001-5 - PubMed
  16. Can J Psychiatry. 2015 May;60(5):203-5 - PubMed
  17. Pharmacoepidemiol Drug Saf. 2011 Sep;20(9):903-13 - PubMed
  18. Circulation. 2009 Feb 10;119(5):728-34 - PubMed
  19. Circulation. 2013 Dec 3;128(23):2532-41 - PubMed
  20. Circ Arrhythm Electrophysiol. 2012 Aug 1;5(4):757-61 - PubMed
  21. Yonsei Med J. 1999 Apr;40(2):144-51 - PubMed
  22. Resuscitation. 2005 Oct;67(1):51-4 - PubMed
  23. Resuscitation. 2009 Nov;80(11):1253-8 - PubMed
  24. Eur Heart J. 2000 Aug;21(15):1251-8 - PubMed
  25. Am J Ther. 2008 Sep-Oct;15(5):474-83 - PubMed

Publication Types