Abstract 18670: Ischemic Stunning in Patients Suffering VT/VF Cardiac Arrests

Introduction: Left ventricular ejection fractions (LVEF) are frequently evaluated following cardiac arrests (CA). LVEFs may be affected by the circumstances of the arrest, or may be relevant in the causation of the arrest. We evaluate immediate LVEF in patients with CA and compare to subsequent LVEF during the index hospitalization. Hypothesis: We expect transient reversible stunning to be present in all patients with CA. Methods: Patients were identified by query of billing for CA from Jan 2010 to May 2014. Records were reviewed for confirmation of CA during that time period, and then demographics and echocardiographic information were collected. Results: Of 145 patients meeting criteria for the study, 80 had a ventricular tachycardia/ fibrillation (VT/VF) arrest and 65 had either an asystolic or pulseless electrical activity (PEA) arrest. The mean initial LVEF was lower in those suffering VT/VF compared to asystolic/PEA arrests (36.4% +/- 16.7 vs 42.4% +/- 19.6; p=0.05). However, there was no difference in subsequent LVEFs (43.7% +/- 16.3 vs 46.1% +/- 17.8; p=0.58). Those diagnosed with STEMI had markedly lower initial LVEFs compared to those without STEMI (29.2% +/- 14.4 vs 41.4% +/- 18.1; p=0.002), but subsequent LVEFs were similar (41.4 +/- 16.8 vs 45.9 +/- 16.7; p=0.33). Conclusions: Patients suffering from VT/VF arrests have lower initial LVEF compared to those with asystolic/PEA arrests. LVEF improve in patients suffering from VT/VF arrests but not in those with asystolic/PEA arrests. Similarly those with STEMI in the context of an arrest suffer from ischemic stunning. Reduced LVEFs in the setting of VT/VF and STEMI arrests should be expected to improve in most patients, arguing for reversible cardiac stunning in those patients.