Prophylactic Anti-aRrhythmic Therapy With Amiodarone in Critically Ill Patients Admitted for an Out-of-hospital Cardiac Arrest With Initial Shockable Rhythm

Inclusion criteria

• Patient aged ≥ 18 years
• Admitted in intensive care unit
• Out-of-hospital cardiac arrest with initial shockable rhythm
• Presumed cardiac or unknown cause
• Delay between ROSC and screening for randomisation < 6 hours
• Informed consent from the patient or a surrogate or deferred consent
• Affiliated to or benefiting from a social insurance

Exclusion criteria

• Cardiac arrest secondary to an extra-cardiac cause (suspected or confirmed)
• Indication for amiodarone decided by the physician at ICU admission
• No central venous catheter available for continuous infusion of amidoarone
• Thyroid disease under treatment
• History of cardiac conduction disorders, not treated by permanent pacemaker
• Any contra indication to amiodarone treatment
• Refractory ventricular arrhythmia or electrical storm
• Need for veno-arterial extracorporeal membrane oxygenation (VA-ECMO) at admission
• Known limitations in therapy and Do Not Resuscitate-order
• Moribund patient due to pre-arrest history (estimated life expectancy < 3 months)
• Pregnant or breastfeeding women
• Patient needing a nadolol treatment due to QT long syndrome or catecholaminergic polymorphic ventricular tachycardia
• Patient with known pulmonary fibrosis
• Patient with known interstitial lung disease