What are the current UK guidelines for post-resuscitation care following successful defibrillation of ventricular fibrillation?

Following successful defibrillation of ventricular fibrillation, UK guidelines recommend immediate post-resuscitation care focused on rapid assessment and management of the underlying cause, particularly acute coronary syndromes. Patients should be assessed urgently for eligibility for coronary reperfusion therapy, such as primary percutaneous coronary intervention (PCI) or fibrinolysis, regardless of age, ethnicity, or sex. Coronary angiography with follow-on primary PCI is preferred if it can be delivered promptly, ideally within 120 minutes of fibrinolysis eligibility, especially if presentation is within 12 hours of symptom onset or if cardiogenic shock is present. Level of consciousness after cardiac arrest should not be used to determine eligibility for coronary angiography. Initial drug therapy includes administering a loading dose of 300 mg aspirin unless contraindicated. Post-resuscitation care also involves monitoring and managing heart failure, including the use of aldosterone antagonists if indicated, and initiating secondary prevention measures such as statin therapy. Cardiac rehabilitation with an exercise component should be offered to all patients after myocardial infarction. Communication of diagnosis, investigations, and future management plans should be clearly documented and shared with the patient. Implantable cardioverter defibrillators (ICDs) or cardiac resynchronisation therapy (CRT) may be considered for patients with reduced left ventricular ejection fraction (≤35%) as part of ongoing management. These recommendations align with NICE guideline NG185 on acute coronary syndromes ¹.