Cardiac Arrest: the Changing Incidence of Ventricular Fibrillation

Steven P. Keller, Henry R. Halperin

Research output: Contribution to journalReview articlepeer-review


There are more than 300,000 out-of-hospital cardiac arrests (OHCA) in the USA annually, which can be grouped into those presenting with tachyarrhythmic (shockable) rhythms and those presenting with non-tachyarrhythmic rhythms. The incidence of tachyarrhythmic rhythms, which include ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT), has been noted to be progressively decreasing in multiple studies of OHCA. Improved medical and surgical therapies for ischemic heart disease, and the widespread use of implantable cardiac defibrillators (ICDs), have likely contributed to a declining incidence of VF arrest and may result in conversion of an otherwise VF event into a pulseless electrical activity (PEA) arrest. As the incidence of VF has declined, it is unclear if the absolute incidence of non-tachyarrhythmic rhythms has increased or remained largely unchanged. This article discusses the changing rates of presenting rhythms in sudden cardiac arrest, the underlying cellular mechanisms of PEA, the factors contributing to the relative increase in the rate of PEA arrests, and current treatment options.

Original languageEnglish (US)
Article number1
JournalCurrent Treatment Options in Cardiovascular Medicine
Issue number7
StatePublished - Jul 22 2015


  • Cardiopulmonary resuscitation
  • Chest compressions
  • Defibrillation
  • Pulseless electrical activity
  • Sudden cardiac arrest
  • Ventricular fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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