Cardiac arrest - Treatments
- Previous page
- page
In this section
Cardiac arrest is a medical emergency. Someone having a cardiac arrest should be given cardiopulmonary resuscitation or electric shock treatment as soon as possible to make their heart start beating normally. Otherwise, they will die. Several drugs have also been tried for cardiac arrest, but we're not sure if they help.
- If you find someone who is having a cardiac arrest, you can try to get their heart started again by using cardiopulmonary resuscitation (CPR). This involves pressing down on the chest and breathing into the mouth. For more, see Cardiopulmonary resuscitation.
- Another way to get the heart started again is to give the heart an electric shock with a machine called a defibrillator. To learn more, see Defibrillation.
- Several drugs have been tried in people having a cardiac arrest. But more research is needed to say whether any can help.
We've looked closely at the research and ranked the drug treatments for cardiac arrest into categories, according to whether they work.
Treatments that need further study
Amiodarone
Amiodarone is a drug that is used to control the electrical signals that tell the heart to beat. It works on the nerves around the heart. It is sometimes given to people who are having a cardiac arrest, when electric shocks have already failed to restart their heart.[1] The brand name for amiodarone is Cordarone.
Amiodarone can cause low blood pressure or a slow heartbeat.[2] But these problems may not be very important to someone who is having a cardiac arrest.
There's no evidence that amiodarone helps people survive a cardiac arrest.[2] [3]
Lidocaine
Lidocaine is a drug that is sometimes used to try to restart the heart when electric shocks haven't worked. The brand name is Minijet Lignocaine.
Lidocaine can cause low blood pressure, so that other drugs have to be given to raise it.[4]
There's no good evidence that lidocaine helps people survive a cardiac arrest.[4] [5]
Procainamide
Procainamide (brand name Pronestyl) is not used very often to treat cardiac arrest. Injecting it into a vein takes several minutes and doctors prefer to use a drug that can get into the body more quickly.[6]
There's no evidence that procainamide can help people survive a cardiac arrest.[7]
Treatments that are unlikely to work
Bretylium
Bretylium isn't available in the UK. It doesn't seem to help people survive a cardiac arrest and it can cause a harmful drop in blood pressure which is difficult to put right.[8]
References
- Resuscitation Council UK. Resuscitation guidelines 2005. Available at: http://www.resus.org.uk/. Last accessed 6 March 2006.
- Kudenchuk PJ, Cobb LA, Copess MK, et al. Amiodarone for resuscitation after out-of-hospital cardiac arrest due to ventricular fibrillation. New England Journal of Medicine. 1999; 341: 871-878.
- Dorian O, Cass D, Schwartz B, et al. Amiodarone as compared with lidocaine for shock-resistant ventricular fibrillation. New England Journal of Medicine. 2003; 347: 955.
- Haynes RE, Chinn TL, Copass MK, et al. Comparison of bretylium tosylate and lidocaine in management of out of hospital ventricular fibrillation: a randomized clinical trial. American Journal of Cardiology. 1981; 48: 353-356.
- Olson DW, Thompson BM, Darin JC, et al. A randomized comparison study of bretylium tosylate and lidocaine in resuscitation of patients from out-of-hospital ventricular fibrillation in a paramedic system. Annals of Emergency Medicine. 1984; 13: 807-810.
- Lang ES, Al Raisi M. Ventricular tachyarrhythmias (out of hospital cardiac arrests). Clinical Evidence. 2006; 15: 295-300.
- Greene HL. The CASCADE Study: randomized antiarrhythmic drug therapy in survivors of cardiac arrest in Seattle. CASCADE Investigators. American Journal of Cardiology. 1993; 72: 70F-74F.
- Nowak RM, Bodnar TJ, Dronen S, et al. Bretylium tosylate as initial treatment for cardiopulmonary arrest: randomized comparison with placebo. Annals of Emergency Medicine. 1981; 10: 404-407.
Glossary
- blood pressure
- Blood pressure is the amount of force exerted by the blood on the walls of the vessels that carry it. You can think of it like the water pressure in your home: the more pressure you have, the faster and more forcefully the water flows out of the shower. Blood pressure is measured in millimetres of mercury (written as mm Hg). When your blood pressure is taken, the measurement is given as two numbers, for example 120/80 mm Hg. The first, higher, number is called the systolic pressure, and the second, lower, number is the diastolic pressure. The systolic number is the highest pressure that occurs while the heart is pushing blood into the arteries. The diastolic number is the lowest pressure that happens when the heart is relaxing and is not pushing the blood.
- low blood pressure
- If your blood pressure is about 100/60 or less, your doctor may say that you have low blood pressure. Low blood pressure is usually not a problem unless it becomes too low to push blood to your brain and the rest of the body. If you have low blood pressure, you may sometimes feel dizzy when you stand up.
© BMJ Publishing Group Limited ("BMJ Group") 2007. All rights reserved
This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
