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A large retrospective analysis of patients presenting with out-of-hospital cardiac arrest with initial non-shockable arrhythmias in King County, Washington, is featured in Circulation (2012;125:1787–94). It provides an interesting insight into the possible impact of the change in emphasis in international resuscitation guidelines (becoming focused on good quality basic life support). One-year survival rates of patients from the 5 years before new Resuscitation Council Guidelines were compared with patients presenting in the 5 years after the guidelines came into force. Despite the (expected) poorer outcome in this group with non-shockable rhythms, there was an improvement in 1-year survival after the change in guidelines.
Ion channels and sudden cardiac death
A fascinating overview of cardiac ion channel disorders and their role in sudden cardiac death has been published in Heart (2012;98:536–43). Much remains to be learned, but the review summarises the current understanding of these disorders, based upon information gained from animal and molecular studies. The role of ion channel disorders in predisposing to cardiac arrhythmias is discussed, together with how greater understanding could lead to …