MEDICAL: CONDITIONS: CARDIAC ARREST: Shockable Cardiac Arrests Are More Common in Public Than Home
David P. Dillard
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MEDICAL: CONDITIONS: CARDIAC ARREST:
Shockable Cardiac Arrests Are More Common in Public Than Home
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Date: Wed, 26 Jan 2011 17:50:03 -0500
From: "NIH OLIB (NIH/OD)" <ol...@od.nih.gov>
To: NIHP...@list.nih.gov
Subject: Shockable Cardiac Arrests Are More Common in Public Than Home
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U.S. Department of Health and Human Services
NATIONAL INSTITUTES OF HEALTH NIH News
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National Heart, Lung, and Blood Institute (NHLBI)
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Embargoed for Release: Wednesday, January 26, 2011, 5 P.M. EST
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CONTACT:
NHLBI Communications Office
e-mail:
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SHOCKABLE CARDIAC ARRESTS ARE MORE COMMON IN PUBLIC THAN HOME
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Comprehensive NIH study helps explain discrepancy in survival rates
between cardiac arrests in public and at home
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Cardiac arrests that can be treated by electric stimulation, also known as
shockable arrests, were found at a higher frequency in public settings
than in the home, according to a National Institutes of Health-funded
study appearing in the Jan. 27 issue of the New England Journal of
Medicine.
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The study compared home and public cardiac arrests under various
scenarios. For example, the study considered whether bystanders or
emergency medical services (EMS) personnel witnessed the cardiac arrest,
and whether the person experiencing the arrest received treatment with an
automatic external defibrillator (AED).
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In every scenario, a higher percentage of public cardiac arrests were
classified as ventricular tachycardia (VT) or ventricular fibrillation
(VF), the types of abnormal heart rhythms that can be treated by electric
shock.
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More than one-third of the people who had a cardiac arrest in public and
were treated with an AED survived. This is a significant improvement over
the roughly 8 percent national average of cardiac arrest survival. In
comparison, the overall survival for home-occurring cardiac arrests
treated with an AED was 12 percent.
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"To improve the overall disappointing outcome for persons experiencing
cardiac arrest, we must know the best immediate treatment," said Susan
Shurin, M.D., acting director of the National Heart, Lung, and Blood
Institute (NHLBI), part of the NIH and the major funding agency of this
study. "This study provides rich data which indicate the need for further
evidence to guide clinical practice and public policy."
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The study is based on data from the world's largest data registry of
pre-hospital cardiac arrest and life-threatening trauma, which is part of
the Resuscitation Outcomes Consortium (ROC). The researchers collected
cardiac arrest data for over 14,000 people between Dec. 2005 and April
2007. The data spanned over 200 EMS agencies and their receiving hospitals
across the United States and Canada.
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Among the key findings were that 79 percent of documented cardiac arrests
in high-traffic public places where AEDs were available and administered,
such as airports or office buildings, were VT or VF. An AED can
automatically diagnose an arrhythmia and shock an arrest victim if
necessary. In contrast, only 36 percent of home cardiac arrests in which
an AED was applied were VT/VF.
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Previous studies have found that home-based cardiac arrests have far lower
survival rates than arrests that occur in public locations. This study
found that only a third of arrests which occurred in homes were witnessed,
while over half of those in public locations had witnesses who could
immediately call 911 and provide assistance.
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The importance of having someone who can provide or call for help does not
exclude the possibility that the types of cardiac arrests occurring in
home may differ from those occurring in public settings, or that those
occurring in public may be more likely to be effectively treated with
electrical stimulation.
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The study noted that this significant contrast in prevalence could be due
to the fact that individuals who spend more time in public places
typically are younger, more active, and have fewer chronic diseases, thus
predisposing them to a different class of arrest.
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However, according to Dr. Shurin, more work is needed to know whether the
differences in rates of rhythms and in outcome are due to underlying
differences in severity of disease or in how rapidly responders provide
effective therapy.
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"These survival results affirm the value of putting AEDs in public
locales," said Myron Weisfeldt, M.D., a cardiologist at Johns Hopkins
University in Baltimore and lead author of the study. "Even though the
overall frequency of VT/VF arrests has declined over the past few decades,
they are still a fairly common occurrence in public settings."
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George Sopko, M.D., ROC project officer and program director in the
NHLBI's Heart Failure and Arrhythmias Branch, added that public awareness
and education are still important. The best chance of surviving a cardiac
arrest, he noted, involves using AEDs in conjunction with cardiopulmonary
resuscitation and immediately calling for medical help.
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ROC was funded in 2004, with renewed funding in 2010, to conduct clinical
research on treatments for life-threatening traumatic injury or cardiac
arrest in real-world settings, typically where patients collapse or are
critically injured, before they reach the hospital. ROC consists of 10
regional clinical centers in the United States and Canada. In addition to
contributing to the ROC database, these sites conduct multiple
collaborative trials and studies aimed at optimizing first-line
resuscitation management strategies to improve patient outcomes.
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The study was supported by the NHLBI in partnership with the National
Institute of Neurological Disorders and Stroke, the U.S. Army Medical
Research & Materiel Command, the Canadian Institutes of Health
Research-Institute of Circulatory and Respiratory Health, Defence Research
and Development Canada, the American Heart Association, and the Heart and
Stroke Foundation of Canada.
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To schedule an interview with an NHLBI spokesperson, contact the NHLBI
Communications Office at
or
e-mail:
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To schedule an interview with Dr. Weisfeldt, contact David March at
or
e-mail:
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For more information on:
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-- Resuscitation Outcomes Consortium, visit
https://roc.uwctc.org/tiki/tiki-index.php
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-- Cardiac Arrest, visit
http://www.nhlbi.nih.gov/health/dci/Diseases/scda/scda_whatis.html
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Part of the National Institutes of Health, the National Heart, Lung, and
Blood Institute (NHLBI) plans, conducts, and supports research related to
the causes, prevention, diagnosis, and treatment of heart, blood vessel,
lung, and blood diseases, and sleep disorders. The Institute also
administers national health education campaigns on women and heart
disease, healthy weight for children, and other topics. NHLBI press
releases, information on NHLBI's role in the American Recovery and
Reinvestment Act, and other materials are available online at
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nervous system. The NINDS mission is to reduce the burden of neurological
disease -- a burden borne by every age group, by every segment of society,
by people all over the world. For more information, visit
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The National Institutes of Health (NIH) -- The Nation's Medical Research
Agency -- includes 27 Institutes and Centers and is a component of the
U.S. Department of Health and Human Services. It is the primary federal
agency for conducting and supporting basic, clinical and translational
medical research, and it investigates the causes, treatments, and cures
for both common and rare diseases. For more information about NIH and its
programs, visit
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##
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This NIH News Release is available online at:
http://www.nih.gov/news/health/jan2011/nhlbi-26.htm
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Sincerely,
David Dillard
Temple University
(215) 204 - 4584
jw...@temple.edu
http://daviddillard.businesscard2.com
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