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Cardiac arrest
Amiodarone after non-shockable-to-shockable conversion
Amiodarone After Conversion From a Non-shockable to a Shockable Rhythm in Out-of-Hospital Cardiac Arrest A Propensity Score-Matched Analysis from the German Resuscitation Registry
Resuscitation · 2026-10 · Added 8 October 2026
German Resuscitation Registry propensity-matched cohort testing whether amiodarone helps OHCA patients whose initial non-shockable rhythm converts to shockable — it was associated with better 24-hour and survival-to-discharge, though not clearly better neurological outcome.
- Study type
- Registry
- Design
- Propensity-score-matched retrospective registry cohort
- Participants
- 5,535 adults with non-traumatic OHCA (1,843 matched pairs)
- Main finding
- Amiodarone was associated with higher admission with ROSC (26.7% vs 23.0%; OR 1.22), 24-hour survival (21.4% vs 14.7%; OR 1.58) and survival to discharge (6.5% vs 4.2%; OR 1.58), but favourable neurological outcome was not statistically significant (3.7% vs 2.9%; OR 1.31, 95% CI 0.91-1.89)
- Caveat
- Retrospective registry data with residual confounding despite matching — the neurologically intact survival signal didn't reach significance, so this is association, not proof
- Bottom line
- Hypothesis-generating
Why it matters in Australia (High relevance). Amiodarone is standard in Australian cardiac arrest care, and rhythm conversion mid-arrest is exactly the scenario crews wonder about dosing — this is directly on-guideline territory.
Learning goal
Weigh the benefits of amiodarone when a non-shockable rhythm converts to shockable during cardiac arrest resuscitation.
More
- Topic: Cardiac arrest
- Daily scan: 8 October 2026
- Podcast: Paramedic Papers Daily, 8 October 2026
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