{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:04:24Z","timestamp":1790726664167,"version":"4.1.0"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>This study aimed to investigate the association between the temporal transitions in heart rhythms during cardiopulmonary resuscitation (CPR) and outcomes after out-of-hospital cardiac arrest.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>This was an analysis of the prospectively collected databases in 3 academic hospitals in northern and central Taiwan. Adult patients with out-of-hospital cardiac arrest transported by emergency medical service between 2015 and 2022 were included. Favorable neurological recovery and survival to hospital discharge were the primary and secondary outcomes, respectively. Time-specific heart rhythm shockability was defined as the probability of shockable rhythms at a particular time point during CPR. The temporal changes in the time-specific heart rhythm shockability were calculated by group-based trajectory modeling. Multivariable logistic regression analyses were performed to examine the association between the trajectory group and outcomes. Subgroup analyses examined the effects of extracorporeal CPR in different trajectories.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>The study comprised 2118 patients. The median patient age was 69.1 years, and 1376 (65.0%) patients were male. Three distinct trajectories were identified: high-shockability (52 patients; 2.5%), intermediate-shockability (262 patients; 12.4%), and low-shockability (1804 patients; 85.2%) trajectories. The median proportion of shockable rhythms over the course of CPR for the 3 trajectories was 81.7% (interquartile range, 73.2%\u2013100.0%), 26.7% (interquartile range, 16.7%\u201337.5%), and 0% (interquartile range, 0%\u20130%), respectively. The multivariable analysis indicated both intermediate- and high-shockability trajectories were associated with favorable neurological recovery (intermediate-shockability: adjusted odds ratio [aOR], 4.98 [95% CI, 2.34\u201310.59]; high-shockability: aOR, 5.40 [95% CI, 2.03\u201314.32]) and survival (intermediate-shockability: aOR, 2.46 [95% CI, 1.44\u20134.18]; high-shockability: aOR, 2.76 [95% CI, 1.20\u20136.38]). The subgroup analysis further indicated extracorporeal CPR was significantly associated with favorable neurological outcomes (aOR, 4.06 [95% CI, 1.11\u201314.81]) only in the intermediate-shockability trajectory.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Heart rhythm shockability trajectories were associated with out-of-hospital cardiac arrest outcomes, which may be a supplementary factor in guiding the allocation of medical resources, such as extracorporeal CPR.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circoutcomes.123.010649","type":"journal-article","created":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T09:08:38Z","timestamp":1715936918000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Prognostic Impact of Heart Rhythm Shockability Trajectory in Out-of-Hospital Cardiac Arrest: A Multicenter Retrospective 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Medicine, National Taiwan University Hospital, Taipei (C.-H.W., T.-C.L., J.T., C.-Y.W., M.-C.W., P.-I.S., C.-L.T., C.-H.H., W.-J.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5649-1684","authenticated-orcid":true,"given":"Pei-I.","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, National Taiwan University Hospital, Taipei (C.-H.W., T.-C.L., J.T., C.-Y.W., M.-C.W., P.-I.S., C.-L.T., C.-H.H., W.-J.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Yen","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan (C.-Y.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4639-1513","authenticated-orcid":true,"given":"Chu-Lin","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, 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