The ARREST trial is a novel randomised-controlled trial aiming to ascertain the best post-resuscitation care pathway for patients without ST-elevation on their ECG.

The study evaluates direct transfer of post-ROSC patients without ST-elevation to a Heart Attack Centre compared to transfer to the nearest Emergency Department.

The trial began in January 2017 and is due to finish in 2020, recruiting a total of 860 patients.

The trial is important and needed because most out-of-hospital cardiac arrests (OHCA) are secondary to acute cardiac ischaemic events. 

There is a clear evidence base for transporting post-ROSC patients with ST-elevation directly to a Heart Attack Centre, but managing post-ROSC patients without ST-elevation is controversial, with a less time-sensitive approach to cardiac intervention.  Significantly, some observational studies have indicated that taking patients without ST-elevation to a HAC may result in significantly better outcomes for these patients.

The trial, funded by the British Heart Foundation, is running at the London Ambulance Service, and will be recruiting pan-London when all sites are live.

Further information about the trial and its background can be found on the trial’s website: