For hospital patients, defibrillation delays mean lower survival

Jan 02, 2008

[B]30 percent of patients receive life-saving defibrillation more than two minutes after cardiac arrest[/B]
An estimated 750,000 hospitalized patients experience cardiac arrest and undergo CPR annually, and less than 30 percent of those leave the hospital alive.

In a paper published in the Jan. 3 issue of the New England Journal of Medicine, researchers quantified the impact of receiving a life-saving electrical shock (defibrillation) among hospitalized patients experiencing a form of cardiac arrest known as ventricular arrhythmia. They found that the chances of survival for hospitalized patients improve dramatically if defibrillation is administered within the expert-recommended two minutes following a cardiac arrest.

Analyzing data from the National Registry of Cardiopulmonary Resuscitation, the authors concluded that 30 percent of patients with cardiac arrest due to ventricular arrhythmia received life-saving defibrillation more than two minutes after initial recognition of their cardiac arrest, a delay that exceeds guidelines-based recommendations. The delayed defibrillation was linked to a significantly lower probability of survival to hospital discharge — 22 percent vs. 39 percent when defibrillation wasn’t delayed—and a 26 percent lower likelihood among survivors of being discharged without major neurological impairment.

The findings also revealed certain hospital characteristics were associated with delayed defibrillation, including small hospital size (fewer than 250 beds); occurrence of cardiac arrest in hospitalized patients whose heart rhythm was not being constantly monitored in specialized units; and occurrence of cardiac arrest after-hours (i.e., nights and weekends).

“While several prior studies have shown an association between defibrillation time and survival, these were relatively small studies that typically included patients whose arrest rhythms would not have benefited from defibrillation” said lead study author Paul S. Chan, M.D, a cardiologist and researcher from Saint Luke’s Mid America Heart Institute. Dr. Chan was previously with the University of Michigan where he initiated the study with University of Michigan cardiologist Brahmajee Nallamothu, M.D., M.P.H., the new paper’s senior author.

The study used a larger, more statistically significant registry of nearly 7,000 patients and focused exclusively on appropriate patients with ventricular arrhythmia. “We found that delayed defibrillation was common, and that rapid defibrillation was associated with sizable survival gains in these high-risk patients,” said Dr. Chan. “However, the real work has yet to be done in this field. We now have to develop systems of care within the hospital to improve defibrillation times nationally.”

“These findings represent a real opportunity to improve patient care,” said Dr. Nallamothu. “We need to understand how delayed defibrillation, which was more common after-hours and in unmonitored settings, relates to the immediate availability of medical personnel or equipment, as well as potential delays in recognition of ventricular arrhythmia.”


Source: University of Michigan Health System

Explore further: Ames test adapted successfully to screen complex aerosols

add to favorites email to friend print save as pdf

Related Stories

Straight to the heart

Aug 18, 2014

A battery-less, wirelessly-powered implantable defibrillator for atrial fibrillation is being developed by an international team of researchers in the UK, Venezuela and the US. With the ability to sense the ...

Are ICDs up to par with patients living longer?

Apr 04, 2011

Most patients with ischemic cardiomyopathy (ICM) and dilated cardiomyopathy (DCM) who have an implantable cardioverter-defibrillator (ICD) now live more than seven years and those ICD patients with hereditary heart disease ...

Recommended for you

Medtronic spends $350M on another European deal

1 hour ago

U.S. medical device maker Medtronic is building stronger ties to Europe, a couple months after announcing a $42.9 billion acquisition that involves moving its main executive offices across the Atlantic, where it can get a ...

Mind over matter for people with disabilities

Aug 26, 2014

People with serious physical disabilities are unable to do the everyday things that most of us take for granted despite having the will – and the brainpower – to do so. This is changing thanks to European ...

Ukraine's former world's tallest man dies

Aug 25, 2014

Ukraine's tallest man, who briefly held the world record but gave it up to live as a recluse, has died due to complications from the condition that saw him never stop growing, local media reported Monday.

User comments : 0