Sudden cardiac arrest is a common but often misunderstood condition in which the heart abruptly stops pumping blood typically in response to the unexpected onset of a chaotic rhythm. The cardiac arrest victim loses consciousness, and if treatment with cardiopulmonary resuscitation (CPR) and defibrillation (heart shock) is not rapidly initiated, the individual will die. Defibrillation converts the chaotic rhythm allowing the heart to resume pumping. For each minute defibrillation is delayed, survival drops by ten percent. In Indiana, only about one person in twenty suffering sudden cardiac arrest outside of a hospital will survive. More than 200,000 U.S. residents die each year of sudden cardiac arrest.
At the Krannert Institute of Cardiology we are at the forefront in both research and clinical care to improve sudden cardiac arrest survival in Indiana communities and in our patients. On a community level, programs have been established to train and equip Indiana law enforcement officers and citizens with automated external defibrillators (AEDs). An AED is capable of automatically determining if defibrillation could benefit a cardiac arrest victim and then providing that therapy. AEDs are reasonably priced at approximately $1500 and non-medically trained persons can learn to use them with about four hours of training. We have shown the benefit of training and equipping volunteer lay responders with AEDs in Indiana communities. Indiana was one of the 24 North American regions conducting the federally sponsored Public Access Defibrillation Trial, a study evaluating the usefulness of AEDs in community facilities. In Indiana, we deployed AEDs in shopping centers, office buildings, hotels, transit centers, and recreational facilities such as health clubs. The study showed that survival for cardiac arrest occurring in facilities equipped with AEDs was double that of those employing cardiopulmonary resuscitation alone. We continue to work with Indiana communities to improve the recognition and treatment of sudden cardiac arrest.
For our individual heart patients seen at the Krannert Institute of Cardiology, we evaluate the possible risk of future sudden cardiac arrest. Although we can never completely know if any one patient will have a cardiac arrest we do know that patients at higher risk include those with poorer heart function (low ejection fraction), those with underlying rhythm abnormalities, and those in whom special testing indicates an irritable heart beat. Patients who have survived a cardiac arrest are also at high risk of a recurrent attack. For such patients we will often recommend the placement of a medical device called an implantable cardioverter-defibrillator or ICD. The ICD is implanted surgically under the skin typically near the left or right collar bone with wires going down into the heart via veins. The ICD continuously monitors the heart rhythm and can both provide heart pacing for too slow of a beat and defibrillation if the heart goes into a chaotic beat. Because the ICD is always watching the heart beat and can automatically recognize and rapidly treat the chaotic rhythm that causes sudden cardiac arrest it is very effective to prevent death. The ICD does require careful monitoring and the surgical implantation has some risk associated with it. Talk to your physician if you have questions whether or not you are a candidate for an ICD.
The goal of the Krannert specialists in heart rhythm evaluation and treatment is to assure that the beat goes on smoothly for our patients and for all Indiana citizens! We are available to discuss individual patient and community concerns regarding the best way to beat sudden cardiac arrest.
