Hi Marco: please refine your question. What do you mean by shockable rhythms? Ventricular rhythms? SV rhythms? A percentage over which denominator? Rhythms in general or rhythms during arrest? If I understand well, all VT/F rhythms during cardiac arrest are shockable, while asystolia and AB blocks are not. If your question is: Which percentage of cardiac arrest present with a shockable rhythm...well it all depends when you are seeing the pattient, as ultimately, all VFs will degenerate into asystole, if you give enough time...I hope this helps. Best.

Great Adrian !!

I refer to  witnessed cardiac arrests (i.e. in the hospital population).  Ventricular fibrillation and pulseless ventricular tachycardia (I know them as shockable rhythms) in which percentage occur? I can imagine a high percentage (over 75%?). However, I know that in non witnessed cardiac arrest  this percentage decreases a lot and asystole and Pulseless electrical activity  ( I know them as non shockable rhythms) are much more frequent . It's correct?

can you give me some references?

marco

In Lombardy Region (that counts 10 Million of inhabitants) in a recent Survey on Prehospital Cardiac Arrest, the percentage (according Utstein Style - 536 patients with arrest bystander witnessed studied) of immediate shockable rhythms was 18.7% and their Rosc 97.0%. The survival rate was 53% and The overall Utstein Survival rate (All Rhithms - All patients) 22.8%.

The fourth dimension (TIME) is the real enemy to fight in prehospital rescue attempt!!!

Hi Guido

Many thanks for your contribution. I am surprised for so low percentage of shockable rhythms. Anymore, Can you share with me the link to the survey you cited ?

Marco

Dear Guido 

I really appreciate your kindness

Dear Marco,  Thank to you for your interesting question.  GFV

HI Marco, You will find very interessant datas in the following paper http://www.ncbi.nlm.nih.gov.gate2.inist.fr/pubmed/22306255 . The authors are making distinctions between cardiac and non-cardiac aetiology among all non-shockable cardiac arrest (FV degenerating in non-shockable rythm vs primary non-shockable rythm for example). The authors also provided very interessing datas on survival and discharge in this particular cohort of patients.

Many many thanks

The link seems don't run (password required). However I find the abstract (http://www.ncbi.nlm.nih.gov/pubmed/?term=22306255). To read the paper subscription is required. I will look for it. 

http://www.ncbi.nlm.nih.gov/pubmed/?term=22306255

Hi Marco

We have just published results from over 22000 in-hospital cardiac arrests where we found an incidence of shockable rhythms (VF/pulselessVT) of 16.9% (Nolan J et al. Resuscitation 2014 85;987-92). The latest London Ambulance Service report for 2013 found incidence for the same criteria of 23.1% in 4466 out of hospital arrests. Hope this helps.

Hi Carl,

many thanks. I have just downloaded your paper

Hello Marco,

Some Swedish data: in the Swedish Cardiac Arrest Registry, I found that 35% of cardiac arrest patients at hospital had VF (38% of those who were monitored by ECG), and 33% of those having out-of-hospital cardiac arrest presented with initial VF.

Concerning TIME, as mentioned by Guido Francesco Villa, I can recommend a little calculation of ours "Improvements in logistics could increase survival after out-of-hospital cardiac arrest in Sweden", presented in J Int Med 2013;273:622-7. Strömsöe A is the first author.

Best wishes

Mats Enlund

Thank to Mats Enlud. The figures in your paper are exhaustive and very useful for my investigation