Trial reportAmerican heart journal2014
Resuscitation Outcomes Consortium-Amiodarone, Lidocaine or Placebo Study (ROC-ALPS): Rationale and methodology behind an out-of-hospital cardiac arrest antiarrhythmic drug trial.
Trial report in American heart journal, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 59 citations in OpenAlex.
- Effect of Time to Treatment With Antiarrhythmic Drugs on Return of Spontaneous Circulation in Shock-Refractory Out-of-Hospital Cardiac Arrest.Journal of the American Heart Association · 2022Trial
- Survival After Intravenous Versus Intraosseous Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Shock-Refractory Cardiac Arrest.Circulation · 2020Trial
- Effects of intra-resuscitation antiarrhythmic administration on rearrest occurrence and intra-resuscitation ECG characteristics in the ROC ALPS trial.Resuscitation · 2018Trial
- Antiarrhythmic Drugs for Nonshockable-Turned-Shockable Out-of-Hospital Cardiac Arrest: The ALPS Study (Amiodarone, Lidocaine, or Placebo).Circulation · 2017Trial
- Beyond Standard Shocks: A Critical Review of Alternative Defibrillation Strategies in Refractory Ventricular Fibrillation.Journal of clinical medicine · 2025Review
- A Framework for Exception From Informed Consent in Trials Enrolling Patients With ST-Segment-Elevation Myocardial Infarction and Cardiogenic Shock.Journal of the American Heart Association · 2025Article
- CPR compression strategy 30:2 is difficult to adhere to, but has better survival than continuous chest compressions when done correctly.Resuscitation · 2021Article
- Rationale and Strategies for Development of an Optimal Bundle of Management for Cardiac Arrest.Critical care explorations · 2020Article
- The Latest in Resuscitation Science Research: Highlights from the American Heart Association's 2017 Resuscitation Science Symposium.Journal of the American Heart Association · 2018Article
- Anti-arrhythmics in out-of-hospital cardiac arrest: lessons from a randomized controlled trial.Journal of thoracic disease · 2016Article
- Amiodarone and lidocaine for shock refractory ventricular fibrillation or ventricular tachycardia in out-of-hospital cardiac arrest: are they really effective?Journal of thoracic disease · 2016Article
- Sudden Cardiac Death in the Young.Circulation · 2016Review
- [Which drugs are useful during resuscitation? Which are not?].Herzschrittmachertherapie & Elektrophysiologie · 2016Review
- Regional incidence and outcome of out-of-hospital cardiac arrest associated with overdose.Resuscitation · 2016Article
- Recreational drug overdose-related cardiac arrests: break on through to the other side.Resuscitation · 2015Article
- Post-operative cardiac arrest induced by co-administration of amiodarone and dexmedetomidine: a case report.Journal of intensive care · 2015Article
- Year in review 2013: Critical Care--out-of-hospital cardiac arrest, traumatic injury, and other emergency care conditions.Critical care (London, England) · 2014Review
Corrections and comments
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Authors and funding
18 authors at 12 institutions in 2 countries.
Funding
Abstract
backgroundDespite their wide use, whether antiarrhythmic drugs improve survival after out-of-hospital cardiac arrest (OHCA) is not known. The ROC-ALPS is evaluating the effectiveness of these drugs for OHCA due to shock-refractory ventricular fibrillation or pulseless ventricular tachycardia (VF/VT).
methodsALPS will randomize 3,000 adults across North America with nontraumatic OHCA, persistent or recurring VF/VT after ≥1 shock, and established vascular access to receive up to 450 mg amiodarone, 180 mg lidocaine, or placebo in the field using a double-blind protocol, along with standard resuscitation measures. The designated target population is all eligible randomized recipients of any dose of ALPS drug whose initial OHCA rhythm was VF/VT. A safety analysis includes all randomized patients regardless of their eligibility, initial arrhythmia, or actual receipt of ALPS drug. The primary outcome of ALPS is survival to hospital discharge; a secondary outcome is functional survival at discharge assessed as a modified Rankin Scale score ≤3.
resultsThe principal aim of ALPS is to determine if survival is improved by amiodarone compared with placebo; secondary aim is to determine if survival is improved by lidocaine vs placebo and/or by amiodarone vs lidocaine. Prioritizing comparisons in this manner acknowledges where differences in outcome are most expected based on existing knowledge. Each aim also represents a clinically relevant comparison between treatments that is worth investigating.
conclusionsResults from ALPS will provide important information about the choice and value of antiarrhythmic therapies for VF/VT arrest with direct implications for resuscitation guidelines and clinical practice.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.