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There are limited data on sex-related differences in out-of hospital cardiac arrests OHCAs with refractory ventricular arrhythmias VA and, in particular, about their relationship with cardiovascular risk profile and severity of coronary artery disease CAD. Aim of this study was to characterize sex-related differences in clinical presentation, cardiovascular risk profile, CAD prevalence, and outcome in OHCA victims presenting with refractory VA.
Whereas in females, no significant survival difference was observed. The refractoriness of arrhythmic events in the male population was probably due to a more complex cardiovascular profile and in particular due to a pre-existing CAD. In females, OHCA with refractory VA were less frequent and no correlation with a specific cardiovascular risk profile was observed.
Keywords: OHCA, shockable rhythm, refractory ventricular arrhythmias, sex, coronary artery disease. In Europe, approximately Although a wide discrepancy in survival has been reported among different countries 2 , some aspects in clinical presentation, including occurrence in a public location, younger age, witness status and shockability of the first rhythm correlate with higher odds of survival 3 , 4.
Among patients with initial shockable rhythm, there is a sizable group of patients who may require multiple shocks to terminate ventricular arrhythmias VA 5. This cohort represents a very challenging OHCA subgroup because of its high mortality rate and the limited data available regarding management 9 , since most patients die before reaching the hospital, and thus no diagnostic work up is possible.