New Findings from ESC Congress 2023: Defibrillators Positively Impact Cardiac Arrest Survival, Even with Rapid Ambulance Arrival
Recent research presented at the ESC Congress 2023 unveils a significant enhancement in the 30-day survival rates of cardiac arrest victims through the application of defibrillators, irrespective of the speed of ambulance response.
The use of defibrillators on individuals experiencing cardiac arrest results in a noteworthy increase in their chances of surviving for 30 days, even when the ambulance arrives within as little as two minutes. These profound revelations emerged from a comprehensive study unveiled at the European Society of Cardiology’s ESC Congress 2023.
The majority of sudden cardiac arrest incidents occur within communities. A specific cardiac arrhythmia known as ventricular fibrillation leads to the heart’s cessation of pumping, causing the halt of blood circulation. Should blood flow restoration not transpire promptly, the affected person loses consciousness and succumbs to the event within a span of 10 to 20 minutes. In this context, the general public can play a pivotal role by promptly summoning an ambulance and engaging in chest compressions, also referred to as cardiopulmonary resuscitation (CPR), while enlisting assistance to locate a defibrillator. The defibrillator is then employed to deliver a high-energy electric shock, effectively restarting the heart.
Insights Derived from the Research
Dr. Mathias Hindborg, the lead author of the study and affiliated with Nordsjaellands Hospital in Hilleroed, Denmark, conveyed, “When an individual collapses due to sudden cardiac arrest, the most efficacious manner in which a bystander can contribute is by performing CPR and employing an automated external defibrillator (AED). Previous inquiries have explored optimal AED placement, but limited information exists regarding the potential impact of ambulance response times on such placement. Consequently, our investigation focused on understanding the influence of AED utilization on survival rates based on ambulance response durations.”
The research drew upon data gleaned from the Danish Cardiac Arrest Registry, spanning incidents from 2016 to 2020. The dataset encompassed variables such as age, gender, location, bystander-administered defibrillation and CPR, ambulance response duration, and the survival status at the 30-day mark following the cardiac arrest event. It’s noteworthy that the study exclusively included adults who experienced witnessed cardiac arrests, received CPR from bystanders, and were reached by an ambulance within 25 minutes or less.
The study’s methodology involved comparing survival probabilities among patients who underwent bystander-administered defibrillation prior to the ambulance’s arrival and those who did not. This analysis was conducted across eight distinct intervals of ambulance response times. Adjustments were made for various influencing factors such as age, gender, the site of arrest (public or private), and pre-existing medical conditions including prior heart attacks or strokes.
Key Findings and Implications
The study sample encompassed 7,471 adults who suffered bystander-witnessed out-of-hospital cardiac arrests and received CPR prior to the ambulance’s arrival. Among them, 14.7% (1,098 out of 7,471) underwent bystander-administered defibrillation before the ambulance’s arrival, while 85.3% (6,373 out of 7,471) did not. Strikingly, 44.5% (489 out of 1,098) of patients who received bystander defibrillation survived for 30 days, as opposed to 18.8% (1,200 out of 6,373) of those who did not receive such intervention.
Survival prospects were notably higher for patients who underwent bystander-administered defibrillation in all intervals of ambulance arrival time, with the exception of the 0 to 2-minute interval, where the increase failed to attain statistical significance. In comparison to scenarios without defibrillation, the likelihood of survival with bystander-administered defibrillation was 37% greater when the ambulance arrived within 2 to 4 minutes, 55% higher for arrivals within 4 to 6 minutes, and approximately twice as high for the remaining studied intervals. The relative risks were calculated at 2.23 for 6 to 8 minutes, 1.99 for 8 to 10 minutes, 1.89 for 10 to 12 minutes, 1.86 for 12 to 15 minutes, and 1.98 for 15 to 25 minutes.
Dr. Hindborg emphasized, “Each patient in our study received CPR, and our findings underscore the supplementary benefit of bystander-administered defibrillation on survival rates. The most notable positive impact of bystander defibrillation on survival probabilities was observed when the ambulance’s arrival time ranged from six to eight minutes. These findings suggest that, when resources are limited, strategically placing defibrillators in regions where ambulance response times tend to exceed six minutes could be paramount.”
In conclusion, he highlighted, “Any individual can contribute to reviving a person grappling with cardiac arrest, be it through CPR, retrieving or operating an AED, or even acquiring an AED for their workplace, community, or residence. Defibrillation undeniably saves lives, and fostering widespread availability of AEDs within communities remains invaluable. However, in situations necessitating prioritization, the insights from this study can serve as a guiding light.”
References:
The abstract titled “Bystander defibrillation increases 30-day survival even with short emergency medical service response time” is scheduled for presentation during the Innovations in public health and health economics (5) session, slated for Monday, August 28, from 17:15 to 18:00 CEST at Station 8.
“European Resuscitation Council Guidelines 2021: Basic Life Support” by Theresa M. Olasveengen, Federico Semeraro, Giuseppe Ristagno, Maaret Castren, Anthony Handley, Artem Kuzovlev, Koenraad G. Monsieurs, Violetta Raffay, Michael Smyth, Jasmeet Soar, Hildigunnur Svavarsdottir, and Gavin D. Perkins, March 24, 2023, Resuscitation.
DOI: 10.1016/j.resuscitation.2021.02.009
Table of Contents
Frequently Asked Questions (FAQs) about Cardiac Arrest Survival
What does the research presented at ESC Congress 2023 reveal?
The research presented at ESC Congress 2023 demonstrates that the use of defibrillators significantly enhances the 30-day survival rates of cardiac arrest victims, regardless of the speed of ambulance response.
How does the study highlight the importance of defibrillators?
The study emphasizes that even when ambulance response times are as short as two minutes, employing a defibrillator on a cardiac arrest victim improves their 30-day survival prospects.
What is the significance of ventricular fibrillation in cardiac arrest?
Ventricular fibrillation, a cardiac arrhythmia, causes the heart to stop pumping, leading to a halt in blood flow. Prompt restoration of blood flow is crucial to prevent unconsciousness and death within minutes.
How can bystanders help during cardiac arrests?
Bystanders play a crucial role by initiating CPR, calling an ambulance, and locating a defibrillator. Defibrillators deliver an electric shock that can restart the heart, contributing to improved survival chances.
What were the key findings of the study?
The study found that bystander-administered defibrillation significantly increases the likelihood of survival, with the most positive impact observed when ambulance response times are around six to eight minutes.
What factors were considered in the study’s analysis?
The study factored in age, gender, location of arrest, bystander defibrillation and CPR, ambulance response time, and pre-existing medical conditions like prior heart attacks or strokes.
How can the study findings influence defibrillator placement?
The study suggests that, in situations with limited resources, defibrillators should be strategically located in areas where ambulance response times are likely to exceed six minutes, maximizing their effectiveness.
What message does Dr. Mathias Hindborg convey?
Dr. Hindborg emphasizes the added benefit of bystander-administered defibrillation on survival rates and encourages a comprehensive approach involving CPR, AED use, and wider accessibility of defibrillators.
Where can I find more information about the study?
You can find more details about the study, including its abstract, at the Innovations in public health and health economics session during ESC Congress 2023.
What other sources are referenced in the study?
The study references the “European Resuscitation Council Guidelines 2021: Basic Life Support” as a source of related information.
How can I contribute to improving cardiac arrest survival rates?
You can play a vital role by learning CPR, familiarizing yourself with AED usage, and advocating for the placement of defibrillators in areas with longer ambulance response times.
1 comment
heard bout this researc @ ESC Cong 23! defibs makin a big diff, even if ambulanc time is short. cool stuff to save hearts ❤️