The Importance of Rapid Defibrillation

Sudden cardiac arrest can occur in victims of all ages at any moment anywhere in the world. Cardiac arrest is defined as the abrupt loss of heart function in a person who may or may not have been diagnosed with heart disease (About, n.d). This condition is often times fatal if swift and precise actions are not taken.

Unfortunately, most cardiac arrest cases occur outside of the hospital with decreased access to medical providers or first responders. In fact, the American Heart Association states that more than 350,000 cardiac arrests occur outside of the hospital each year.

If those statics aren’t scary enough about 90 percent of all out of hospital cardiac arrest victims do not survive. Why is that?

Studies show that only 46 percent of victims with an out of hospital cardiac arrest receive immediate bystander intervention needed before medical professionals arrive.  (About, n.d.) Cardiopulmonary resuscitation, also known as CPR, is paramount when a victim is in cardiac arrest. When a victim is in cardiac arrest, the electrical pathways within the heart are significantly impaired and may cause life threatening arrhythmias known as ventricular fibrillation (VF), ventricular tachycardia (VT), pulseless electrical activity or asystole.

In all of these rhythms the heart is not effectively pumping blood flow throughout the rest of the body and therefore a pulse is not present. It is paramount to call 911, have someone find the nearest automated external defibrillator (AED) and initiate CPR at an appropriate rate and depth. The average medical response time in the United States is approximately 7 minutes and many rural areas or areas with high volume traffic could expect even longer response times. (Mell, Mumma, Hiestand, Carr, Holland & Stopyra, 2017).

Although CPR is effective in circulating blood flow through the body, a sudden cardiac arrest victim requires immediate defibrillation to stop ventricular fibrillation. In ventricular fibrillation the ventricles, or lower chambers of the heart, are quivering and not effectively pumping blood. The defibrillation delivered from an AED attempts to “stun” the heart and allow the heart’s primary pacemaker known as the sinoatrial node to reestablish a normalized rhythm.

Early defibrillation is critical for survival from cardiac arrest for several reasons:

• The most frequent initial rhythm in witnessed sudden cardiac arrest is VF;
• The most effective treatment for VF is electrical defibrillation;
• The probability of successful defibrillation diminishes rapidly over time; and
• VF tends to convert to asystole within a few minutes (AED,2000).

For every 1 minute without CPR or defibrillation from an AED, the victim’s chance of survival decreases by 7-10 percent (Cardiac Science, n.d.) 

Early recognition, activation of emergency response and rapid initiation of CPR and early defibrillation are crucial to successful outcomes of sudden cardiac arrest victims.

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References 

Automated External Defibrillator (AED). (2000, August 22). Retrieved February 7, 2021, from https://www.ahajournals.org/doi/10.1161/circ.102.suppl_1.I-60

About Cardiac Arrest. (n.d.). Retrieved February 7, 2021, from https://www.heart.org/en/health-topics/cardiac-arrest/about-cardiac-arrest

Cardiac Science. (n.d.). LIVES LOST: The Case for AEDs in Your Community. Retrieved from https://ohsonline.com/whitepapers/2010/06/lives-lost-case-aed-community.aspx?m=1

Mell, H. K., Mumma, S. N., Hiestand, B., Carr, B. G., Holland, T., & Stopyra, J. (2017, October 01). Emergency Medical Services Response Times in Rural, Suburban, and Urban Areas. Retrieved February 7, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5831456/