Analysis highlights impact of rapid initial shock after cardiac arrest

It is well known that acting quickly is important in the event of cardiac arrest, but what exactly does a quick initial shock with a defibrillator mean for patients’ chances of survival? Researchers from Amsterdam UMC analyzed data from 3,723 patients who suffered heart attacks outside hospital and concluded that every minute of initial shock reduces the chance of survival by 6%.

The results of this research were published in the journal Circulation.

“Our research shows that every minute delay in delivering the first shock has a huge impact. If the first shock was given within six minutes, it was possible to stop the cardiac arrhythmia in 93 percent of cases.” ventricular fibrillation (VF)—causes cardiac arrest. For example, if the first shock is delayed and only given after more than 16 minutes, this percentage drops to 75%,” says Remy Stieglis, researcher at Amsterdam UMC.

The study shows that every minute of delay until the first shock results in a 6% lower chance of survival to hospital discharge.

Since 2005, the ARREST study (Amsterdam REsuscitation Studies) has been collecting detailed data on this topic. animation In collaboration with emergency services and hospitals in North Holland. Data for this particular study was collected from those suffering from a disorder. cardiac arrestcaused by VF in the presence of a witness.

This allowed the time from the emergency call to the first shock to be determined very accurately and therefore to analyze the impact from this moment to the first shock.

“After a successful shock (defibrillation), VF terminates and converts to a normal heart rhythm or a heart rhythm that disappears completely (asystole). In our study, a shorter delay to the first shock also resulted in a more frequent relapse of the normal heart rhythm to 100,000 m2.” After a successful shock, VF may reoccur, which may require another shock, and this chance is also reduced due to the shorter time until the first shock,” says Christian van der Werf, cardiologist and researcher at Amsterdam UMC.

Outcomes after cardiac arrest can be improved by investing in the entire chain to shorten the time from emergency call to first shock.

“In the Netherlands, a lot of work is being done to provide a rapid initial shock through the deployment of first responders (e.g. first responders, police and/or fire department via HeartbeatNu) and the many AEDs available, but three out of four resuscitations require ARREST resuscitation.” We did not reach this six minutes in our study,” says study leader and anesthesiologist Hans van Schuppen.

“To achieve this goal in all stimulus, more central control and more research are needed, with concrete actions. This also needs to be given more attention abroad, to keep the time until the first shock as short as possible. Our data shows that this is working.”