Abstract 15866: Relative Wall Thickness in Shockable vs. Non-shockable Sudden Cardiac Arrest in the Community

Introduction: Shockable initial rhythms (VT/VF) during sudden cardiac arrest (SCA) are associated with considerably better resuscitation outcomes than non-shockable rhythms (pulseless electrical activity [PEA] or asystole), but factors associated with these arrhythmias are poorly understood. By analyzing archived echocardiogram reports, we examined the potential role of relative wall thickness (RWT) as a determinant for shockable vs. non-shockable SCA. Methods: All SCA victims in a Northwest US metro region (population 1 million) were prospectively identified 2002 - 2015, and their medical records reviewed. 385 subjects with an echocardiogram performed prior to SCA, and with documented initial SCA rhythm available were included in the analysis. Association of RWT (2xPWd/LVEDD) and LV ejection fraction (EF) with initial rhythm was studied. Results: Initial rhythm was VT/VF in 178 (46%) and non-shockable (PEA/asystole) in 207 (54%) subjects. Subjects with VT/VF were younger (65.6±13.5 vs 68.6±13.4yrs, p=0.032) and more likely male (77.5% vs 59.9%, p 0.56). Conclusions: In the community, decreased RWT was strongly associated with VT/VF as the initial rhythm in SCA. These findings have mechanistic and clinical implications for improving resuscitation outcomes from SCA.