Out-of-Hospital Cardiac Arrest in the Presence of Ischemic Heart Disease: What Is the Long-term Arrhythmic Risk After Revascularization?

Patients resuscitated from out-of-hospital cardiac arrest (OHCA) frequently have underlying coronary artery disease (CAD), but the relationship between the arrest and myocardial ischemia or infarction due to CAD can be difficult to discern in clinical practice. Patients often present with clinical profiles that guideline recommendations for appropriate implantable cardioverter-defibrillator use do not address. In cases of incomplete revascularization or mild but sustained impairment of ventricular function, it is not clear if the cause of the cardiac arrest is completely "reversible." We describe distinct phenotypes of patients with OHCA and concomitant CAD and highlight current knowledge gaps in their management and outcomes.