To determine the prevalence and association of antecedent bradycardia with outcome in adult patients with IHCA occurring outside the ICU.Methods We performed a retrospective cohort study among telemetry monitored adults with IHCA outside the ICU in a two-hospital health system between 2008 and 2010 with follow-up until their discharge or death in-hospital.
We defined (1) IHCA as >1 min of chest compressions or trans-thoracic defibrillation, (2) Antecedent bradycardia as at least 2 min of continuous heart rate between 1 and 59 beats per minute in the 10 min preceding IHCA, and (3) ventricular tachyarrhythmia arrests as presence of sustained ventricular tachyarrhythmia for >20 s in the 10 min preceding IHCA.
Of 98 IHCAs, 39 (39.8 % ) survived to hospital discharge. Of 98 IHCAs, 53 (54.1 % ) had antecedent bradycardia. After adjusting for potential confounders, antecedent bradycardia was associated with death prior to hospital discharge (adjusted OR = 3.80, 95 % CI: 1.47-9.81, p = 0.006). Among patients with ventricular tachyarrhythmia arrests, antecedent bradycardia was associated with a higher risk of death (OR = 13.1, 95 % CI 1.92-89.5, p = 0.009).
Antecedent bradycardia occurred frequently and was associated with death prior to hospital discharge in non-ICU hospitalized adults on telemetry monitoring who developed IHCA.