Abstract 15381: Mechanical Chest Compression or Percutaneous Left Ventricular Assist Devices Improve Survival in Cardiac Arrest in the Cath Lab
Introduction: Ventricular fibrillation cardiac arrest (VFCA) can occur during high risk percutaneous coronary intervention. While the operator attempts to reopen the acutely occluded vessel, several options are available to maintain vital organ perfusion. These include manual chest compressions, mechanical chest compressions, and percutaneous left ventricular assist devices (PLVAD).
Hypothesis: We used a swine model to study the survival and neurologic outcomes using these different strategies after 12 min of proximal left anterior descending (LAD) occlusion and 16 min of VFCA. We hypothesize that mechanical devices will yield superior outcomes compared to manual chest compressions.
Methods: Sixty-one swine were studied (55-60 kg). The proximal LAD was occluded with a coronary balloon and confirmed with angiography. Ventricular fibrillation was induced and circulatory support was provided with either manual chest compressions (n=10), mechanical chest compressions with the Lund University Cardiac Arrest System, (LUCASTM) (n=17), or the Impella 2.5 L (Abiomed, Danvers) PLVAD (n=18). At 12 minutes, the balloon was deflated to restore coronary flow and defibrillation attempted at 16 minutes. Primary outcomes were ROSC and 24-hour favorable neurological function (CPC 1 or 2).
Results: There were no significant differences in sex and weight between the three groups. The baseline ejection fraction was 55% for the LUCAS as well as the PLVAD group, which declined post resuscitation to 44% and 32%, respectively (p<0.02).
Conclusions: Mechanical devices provided superior 24-hour survival with good neurologic recovery compared to manual compressions during moderate duration VFCA associated with an acute coronary occlusion in the cath lab. Despite a high percentage of ROSC (64%), only about 1/3 of these subjects recovered with good neurologic function. Combining the 2 mechanical devices may further improve outcomes.
- Cardiac arrest
- Ventricular assist devices
- Ventricular fibrillation
- Percutaneous coronary intervention (PCI)
- Cardiopulmonary resuscitation
Author Disclosures: H. Truong: None. K. Cha: None. R. Oliveira: None. N. Smith: None. T. Bien: None. P. Rao: None. S. Chatelain: None. M. Kern: None. K. Lotun: None. K.B. Kern: None.
- © 2016 by American Heart Association, Inc.