Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden cardiac arrest is a major health problem in the US.1
Summary
Sudden Cardiac Arrest
Sudden cardiac arrest and subsequent death is a major health problem, claiming over 450,000 lives every year in the US.1
What Is Sudden Cardiac Arrest?
Sudden cardiac arrest (SCA) is the sudden, abrupt loss of heart function generally caused by ventricular tachycardia (VT) or ventricular fibrillation (VF).
An electrical conduction problem, sudden cardiac arrest is not the same as a heart attack or myocardial infarction (MI), which is caused by a blocked vessel leading to loss of blood supply to a portion of the heart muscle.
In approximately 94 to 95% of cases, sudden cardiac arrest is fatal, leading to sudden cardiac death.2
Who Is at Risk for Sudden Cardiac Arrest?
While there is no standard list of sudden cardiac arrest symptoms and it typically occurs without warning, sudden cardiac arrest risk factors1-3 include:
- Survival of a previous SCA episode
- Previous MI even if with optimal management including ace-inhibitors and beta blocker therapy
- Low ejection fraction – 40% or less
- History of heart disease or heart rhythm disorders
- Family history of sudden cardiac arrest or other heart disease
- Premature ventricular complexes (PVCs) and ventricular tachycardia
Treatment Options
Sudden cardiac arrest can be reversed, but only if treated within minutes with an electrical cardioverter shock via an automated external defibrillator (AED) or with an implantable cardioverter defibrillator (ICD). The American Heart Association recommends defibrillation within 3 to 5 minutes of arrest, or sooner, for sudden cardiac arrests occurring outside the hospital.4 In the US, on average, it takes emergency medical services teams 6 to 12 minutes to arrive.5 Sudden cardiac arrest survival rates drop 7 to 10 percent for every minute without defibrillation.6
The Cost of ICD Therapy
Evidence-based medicine has demonstrated that ICDs significantly reduce death among Americans at highest risk.
Despite these statistics, ICDs are underutilized.
- Fewer than 20% of currently indicated patients receive the benefits of an ICD despite being at high risk for sudden death7
References
1
Zheng Z-J, Croft JB, Giles WH, Mensah GA. Sudden cardiac death in the United States, 1989-1998. Circulation. 2001;104:2158-63.
2
Pell JP, Sirel JM, Marsden AK, et al. Presentation, management, and outcome of out-of-hospital cardiopulmonary arrest: comparison by underlying etiology. Heart. 2003;89:839-42.
3
Moss AJ, Zareba W, Jackson Hall W, et al., for the MADIT II investigators. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. 2002;346:877-83.
4
American Heart Association, Inc., Guidelines 2000 for cardiovascular resuscitation and emergency cardiovascular care. Circulation. 2000;102:I1-I384.
5
Medtronic review of published clinical literature.
6
Cummins RO. From concept to standard-of-care? Review of the clinical experience with automated external defibrillators. Ann Emer Med. 1989,18:1269-75.
7
Cardinal DS, Connelly DT, Steinhaus DM, et al. Cost savings with nonthoracotomy implantable cardioverter defibrillators. Am J Cardiol. 1996; 78:1255-59.