CHAPTER 30 AMIODARONE IN VENTRICULAR FIBRILLATION

Amiodarone as Compared with Lidocaine for Shock-resistant Ventricular Fibrillation

Dorian P, Cass D, Schwartz B, et al. N Engl J Med. 2002;346:884–890

BACKGROUND

Ventricular fibrillation (VF) is a commonly encountered rhythm and often the most survivable form of out-of-hospital cardiac arrests. Some cases are resistant to conversion by defibrillation, and the addition of pharmacologic antiarrhythmics to defibrillation has become the standard of care supported by clinical guidelines for refractory VF. At the time of this study, lidocaine was the drug of choice for refractory VF; however, little evidence supported its use. This study compares amiodarone to lidocaine for shock-resistant VF.

OBJECTIVES

To compare the efficacy and mortality associated with the use of amiodarone when compared to lidocaine in shock-resistant VF in out-of-hospital cardiac arrests.

METHODS

Double-blinded, randomized trial done in the Toronto Emergency Medical Services (EMS) system between 1991 and 2001.

Participants

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