Acute cardiac care & resuscitationMeta-analysis
Antiarrhythmic drugs for cardiac arrest with a shockable rhythm and their effect on outcomes – A systematic review with meta-analysis
- Systematic review and meta-analysis
- subgroup analysis by study design
Authors' conclusion
Evidence supporting the use of any antiarrhythmic drugs during CPR remains limited and is partly inconclusive. For the effect on survival to hospital discharge, a statistically significant difference was only found favouring the administration of lidocaine compared to no lidocaine.
Study context
- Population
- Cardiac arrest with a shockable rhythm
- Participants
- 60,205 participants · 29 studies
- Comparison
- Antiarrhythmic drugs vs comparators during cardiopulmonary resuscitation (CPR) for shockable rhythm
Pooled result
As reported in the abstract
Return of spontaneous circulation (ROSC)
Odds ratio (95% CI)P value
Lidocaine vs No lidocaine
1.61(1.11–2.32)
P = 0.01Nifekalant vs Lidocaine
4.18(2.23–7.83)
P < 0.00001Esmolol vs No esmolol
3.0(1.40–6.40)
P = 0.005Further pooled results
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Survival to hospital discharge | 1.66 (1.02–2.7) | P = 0.04 | |
| 0.20.5125Odds ratio (log scale) |
Original publication
Antiarrhythmic drugs for cardiac arrest with a shockable rhythm and their effect on outcomes – A systematic review with meta-analysis. Europace. Published 14 November 2025. doi:10.1093/europace/euaf289
Summarised from the published abstract; every number is checked against it