• Andreas Kliegel, Philip Eisenburger, Fritz Sterz, Michael Holzer, Heidrun Losert, Christof Havel, Günter Stix, and Anton N Laggner.
• Department of Emergency Medicine, University of Vienna, Vienna, Austria.
• Resuscitation. 2002 Sep 1; 54 (3): 237-43.

ObjectivesThe recurrence rate of lethal cardiac events after the survival of a primary cardiac arrest in patients not having received an implantable cardioverter defibrillator (ICD) is investigated.BackgroundAccording to current guidelines, only a small percentage of patients after successful cardiopulmonary resuscitation due to an underlying cardiac problem are eligible for the implantation of an ICD.MethodsFor retrospective analysis, we used a data registry of patients admitted to an emergency department after cardiac arrest. Patients who had a primary cardiac cause for their cardiac arrest and who did not die within the first month after successful restoration of spontaneous circulation were selected.ResultsFrom 1246 patients, 360 met the inclusion criteria. A second lethal cardiac event occurred in 94 (26%). Of those 94 patients, 57 (61%) had good neurological function before their second cardiac arrest. Of the survivors with good neurological function, 47 (82%) did not have an ICD or a cardiac transplant. Another cardiac arrest due to a primary cardiac event occurred in 34 (72%) of these patients.ConclusionsCardiac arrest survivors without an apparent indication for an ICD have a high risk of suffering from a re-arrest of cardiac origin.

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