Current treatment of patients surviving out-of-hospital cardiac arrest

Article Abstract:

Sudden cardiac death (SCD) kills over 350,000 Americans each year, making it the most common cause of death among adult men under age 64, and a frequent cause of death among men and women of all ages. In most cases, an abnormal rhythm (arrhythmia) of the ventricles is the cause of out-of-hospital death, unrelated to acute myocardial infarction (heart attack). Although patients may survive long enough to reach the hospital, only 15 percent to 30 percent survive to leave the hospital. One study showed that half of cardiac arrest victims who were discharged from the hospital were alive two years later, and 40 percent were alive four years later. The first six months after discharge were the most dangerous. Survival is more likely when SCD is caused by ventricular fibrillation (rapid, disorganized heartbeat); in these cases, the time between collapse and the first defibrillation attempt is the most important determinant of survival. Heart conditions associated with SCD among various age groups are discussed. The role of electrophysiological testing, antiarrhythmic drug testing, and electrophysiologically guided drug therapy are outlined, as well as surgical procedures such as angioplasty (insertion of a balloon into an artery to compress fatty deposits) and coronary artery bypass. The use of an automatic implantable cardioverter-defibrillator (AICD system) is recommended for those patients who have suffered cardiac arrest, and whose arrhythmia does not respond to drug therapy. At most experienced centers, death immediately after surgical implant of an AICD happens about once in 33 surgeries, and minor complications occur in 10 percent to 20 percent. Given the high risk of death from SCD, the best solution is prevention through risk factor modification, but short term solutions also include better resuscitation techniques and prevention of recurrences. (Consumer Summary produced by Reliance Medical Information, Inc.)

Patient outcomes, Mortality, Prevention, Causes of

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Predictive Value of the Electrocardiogram in Acute Coronary Syndromes

Article Abstract:

Specific patterns on an electrocardiogram (ECG) may predict which patients with chest pain will have a heart attack. An ECG measures the electrical activity of the heart. It is important to quickly diagnose heart attack so that drugs can be given to break up the blood clots that cause heart attacks. Two 1999 studies show that some ECG patterns are accurate in diagnosing heart attack and some are not. Whatever pattern is used, its effectiveness must be tested in clinical trials. The ECG pattern could be combined with other diagnostic aids and imaging techniques.

Editorial, Diagnosis, Heart attack, Electrocardiogram, Electrocardiography

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Improving Survival From Sudden Cardiac Arrest: The Role of the Automated External Defibrillator

Article Abstract:

Automated external defibrillators are so small and easy to use that even non-medical personnel can be trained to use them. Defibrillators are used to deliver an electric shock to the heart of a person in cardiac arrest. This will allow these patients to be treated sooner, which may improve their prognosis.

Evaluation, Defibrillators

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