Thrombolytic therapy vs primary percutaneous intervention after ventricular fibrillation cardiac arrest due to acute ST-segment elevation myocardial infarction and its effect on outcome

Post-cardiac arrest syndrome: Epidemiology, pathophysiology, treatment, and prognostication: A Scientific Statement from the International Liaison Committee on Resuscitation; the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; the Council on Stroke (Part 1)

“…If there are no facilities for immediate PCI, in-hospital thrombolysis is recommended for patients with ST elevation who have not received prehospital thrombolysis (Antman et al, 2004;Richling et al, 2007). Although the efficacy and risk thrombolytic therapy has been well characterised in post-cardiac arrest patients (Richling et al, 2007;Schreiber et al, 2002;Kurkciyan et al, 2003), the potential interaction of mild therapeutic hypothermia and thrombolytic therapy has not be formally studied.…”

“…Although the efficacy and risk thrombolytic therapy has been well characterised in post-cardiac arrest patients (Richling et al, 2007;Schreiber et al, 2002;Kurkciyan et al, 2003), the potential interaction of mild therapeutic hypothermia and thrombolytic therapy has not be formally studied. Theoretical considerations include possible impact on the efficacy of thrombolysis and the risk of haemorrhage.…”

Post–Cardiac Arrest Syndrome

“…13,14,160 If no facilities are available for immediate PCI, in-hospital thrombolysis is recommended for patients with ST elevation who have not received prehospital thrombolysis. 173,174 Although the efficacy and risk of thrombolytic therapy have been well characterized in post-cardiac arrest patients, 174 -176 the potential interaction of mild therapeutic hypothermia and thrombolytic therapy has not been studied formally. Theoretical considerations include a possible impact on the efficacy of thrombolysis and the risk of hemorrhage.…”

Post Cardiac Arrest Syndrome

“…64,65 If no facilities are available for immediate PCI, thrombolysis should be considered for patients with STEMI after OHCA. 66,67 The potential interaction between thrombolysis and TH has not been well studied, with possible issues of efficacy of thrombolysis and increased risk of hemorrhage.…”