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Aims The long-term outcomes of patients treated with extracorporeal cardiopulmonary resuscitation (ECPR) for refractory ventricular tachycardia/ventricular fibrillation (VT/VF) out-of-hospital cardiac arrest (OHCA) remain poorly defined. The purpose of this study was to describe the hospital length of stay and long-term survival of patients who were successfully rescued with ECPR after refractory VT/VF OHCA. Methods and results In this retrospective cohort study, the length of index admission and long-term survival of patients treated with ECPR after OHCA at a single centre were evaluated. In a sensitivity analysis, survival of patients managed with left ventricular assist device (LVAD) implantation or heart transplantation during the same period was also evaluated. Between 1 January 2016 and 12 January 2020, 193 patients were transferred for ECPR considerations and 160 underwent peripheral veno-arterial extracorporeal membrane oxygenation cannulation. Of these, 54 (33.7%) survived the index admission. These survivors required a median 16 days of intensive care and 24 days total hospital stay. The median follow-up time of the survivors was 1216 (683, 1461) days. Of all, 79.6 and 72.2% were alive at 1 and 4 years, respectively. Most deaths within the first year occurred among the patients requiring discharge to a long-term acute care facility. Overall survival rates at 4 years were similar in the ECPR and LVAD cohorts (P = 0.30) but were significantly higher for transplant recipients (P < 0.001). Conclusion This data suggest that the lengthy index hospitalization required to manage OHCA patients with ECPR is rewarded by excellent long-term clinical outcomes in an expert ECPR programme.

The long-term outcomes of patients treated with extracorporeal cardiopulmonary resuscitation (ECPR) for refractory ventricular tachycardia/ventricular fibrillation (VT/VF) out-of-hospital cardiac arrest (OHCA) remain poorly defined. The purpose of this study was to describe the hospital length of stay and long-term survival of patients who were successfully rescued with ECPR after refractory VT/VF OHCA.In this retrospective cohort study, the length of index admission and long-term survival of patients treated with ECPR after OHCA at a single center were evaluated. In a sensitivity analysis, survival of patients managed with left ventricular assist device (LVAD) implantation or heart transplantation during the same period was also evaluated.Between 1/1/2016 and 12/1/2020, 193 patients were transferred for ECPR considerations and 160 underwent peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) cannulation. Of these, 54 (33.7%) survived the index admission. These survivors required a median 16 days of intensive care and 24 days total hospital stay. The median follow-up time of the survivors was 1,216 [683, 1461] days. 79.6% and 72.2% were alive at one and four years, respectively. Most deaths within the first year occurred among the patients requiring discharge to a long-term acute care facility. Overall survival rates at four years were similar in the ECPR and LVAD cohorts (p = 0.30) but were significantly higher for transplant recipients (p 0.001).This data suggest that the lengthy index hospitalization required to manage OHCA patients with ECPR is rewarded by excellent long-term clinical outcomes in an expert ECPR program.

Background Sudden cardiac death (SCD) is a relatively common mode of death in patients with heart failure preserved ejection fraction (HFpEF). However, the spectrum and burden of cardiac arrhythmias, particularly those of ventricular arrhythmias, has not well established in these patients. Methods We performed routine arrhythmia surveillance using a 14-day adhesive patch ambulatory ECG recorder (ZioPatch) in patients with HFpEF, enrolled in a subspecialty heart failure clinic. Cardiac electrophysiologists interpreted the ECG recordings. We extracted the clinical data from electronic medical records. Results A total of 40 patients (mean age 71.1±9.9 years, 53% women) with HFpEF underwent routine Ziopatch monitoring. Mean ejection fraction was 59.4±4.4% and 44% had history of coronary artery disease. Of the 40 patients, 32.5% had episodes of non-sustained ventricular tachycardia (VT) (mean 5±5.2 episodes), 15.0% had paroxysmal atrial fibrillation and 80.0% had episodes of supraventricular tachycardia during the monitored period. All patients had premature ventricular complexes (PVC) with 7.5% having a PVC burden that exceeded 5%. Patients with non-sustained VT had a relatively lower EF, higher NT-proBNP level and were more likely to be obese (Table). Conclusion Patients with HFpEF have a high, and possibly underappreciated, burden of cardiac arrhythmias. The frequent episodes of non-sustained VT in these patients may provide insight into the mechanism of SCD in HFpEF.

An association between Atrial Fibrillation (AF) and malignant cancer is being increasingly recognized. Traditional risk scores have not been validated in patients with cancer and AF and role of cancer-specific factors is unknown. A previously validated risk tool [Khorana Score, KS] can identify