The effect of initial rhythm on patient outcome in refractory cardiac arrest requiring extracorporeal…

Cohort studyCritical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine· Sep 2026

The effect of initial rhythm on patient outcome in refractory cardiac arrest requiring extracorporeal cardiopulmonary resuscitation: A retrospective, multicentre registry cohort study.

Wafira Y Wilson, Kerina J Denny, James P A McCullough … James R Winearls

Resuscitation & Cardiac ArrestCohort studyPrognosisQ1IF 2.3

Shockable initial rhythm linked to higher favorable 6-month survival after extracorporeal cardio pulmonary resuscitation.

The effect of initial rhythm on patient outcome in refractory cardiac arrest requiring extracorporeal cardiopulmonary resuscitation: A retrospective, multicentre registry cohort study.

Wafira Y Wilson … James R Winearls

Critical care and resuscitation · Sep 2026

Purpose

To determine the effect of initial rhythm on 6-month survival with favourable functional outcomes in patients supported with extracorporeal cardio pulmonary resuscitation (extracorporeal cardio pulmonary resuscitation) for in-hospital cardiac arrest and out-of-hospital cardiac arrest (IHCA and OHCA).

Methods

This multicentre cohort study used secondary data from the EXCEL registry, a binational extracorporeal membrane oxygenation (extracorporeal membrane oxygenation) database across Australia and New Zealand.

n = 249 patients

Results

Favorable survival rate was about double with a shockable versus nonshockable arrest rhythm.

Shockable

21%

Nonshockable

11%

More results

Among 249 patients, 123 (49.4%) had an initial shockable rhythm and 126 (50.6%) had a nonshockable rhythm.

Overall, 16% (40/249) survived with favourable functional outcomes.

Unemployment due to health issues at 6 months was similar between the shockable (14/40 [35%]) and nonshockable (12/32 [37.5%]) groups (p = 0.826).

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Conclusion · 1 of 2

An initial shockable rhythm was associated with higher 6-month survival with favourable functional outcomes after extracorporeal cardio pulmonary resuscitation.

Conclusion · 2 of 2

Larger studies are needed to confirm whether rhythm-guided selection may improve patient outcomes.

The effect of initial rhythm on patient outcome in refractory cardiac arrest requiring extracorporeal cardiopulmonary resuscitation: A retrospective, multicentre registry cohort study.

The effect of initial rhythm on patient outcome in refractory cardiac arrest requiring extracorporeal cardiopulmonary resuscitation: A retrospective, multicentre registry cohort study.

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