Author + information
- Received July 17, 2017
- Accepted July 24, 2017
- Published online September 11, 2017.
- aUniversity of Washington-Harborview Center for Prehospital Emergency Care, University of Washington, Seattle, Washington
- bDivision of Emergency Medicine, University of Washington, Seattle, Washington
- cCardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital Umberto, Lancisi, Salesi, Ancona, Italy
- dDepartment of Cardiology, University of Washington, Seattle, Washington
- ↵∗Address for correspondence:
Dr. Graham Nichol, University of Washington-Harborview Center for Prehospital Emergency Care, Box 359727, Seattle, Washington 98104.
Cardiac arrest is defined as the termination of cardiac activity associated with loss of consciousness, of spontaneous breathing, and of circulation. Sudden cardiac arrest and sudden cardiac death (SCD) are terms often used interchangeably. Most patients with out-of-hospital cardiac arrest have shown coronary artery disease or symptoms during the hour before the event. Cardiac arrest is potentially reversible by cardiopulmonary resuscitation, defibrillation, cardioversion, cardiac pacing, or treatments targeted at the underlying disease (e.g., acute coronary occlusion). We restrict SCD hereafter to cardiac arrest due to ventricular fibrillation, including rhythms shockable by an automatic external defibrillator (AED), implantable cardioverter-defibrillator (ICD), or wearable cardioverter-defibrillator (WCD). We summarize the state of the art related to defibrillation in treating SCD, including a brief history of the evolution of defibrillation, technical characteristics of modern AEDs, strategies to improve AED access and increase survival, ancillary treatments, and use of ICDs or WCDs.
- automated external defibrillator
- cardiac arrhythmias
- cardiopulmonary resuscitation
- emergency medical services
- out-of-hospital cardiac arrest
Dr. Nichol has received funding from the U.S. Food and Drug Administration and from Zoll Medical Corp. as principal investigator for the Dynamic Automatic External Defibrillator Registry; and has consulted for Zoll Circulation Inc. Dr. Sayre has received travel reimbursement from Physio-Control Inc. Dr. Poole is a compensated consultant for Kestra Inc.; and has received honoraria and travel reimbursement from Biotronik, Boston Scientific, Abbott, and Medtronic; and has received honoraria, travel fees, and research funding from Boston Scientific. Dr. Guerra has reported that he has no relationships relevant to the contents of this paper to disclose. Kalyanam Shivkumar, MD, PhD, served as Guest Editor for this paper.
- Received July 17, 2017.
- Accepted July 24, 2017.
- 2017 American College of Cardiology Foundation
- Central Illustration
- Disparities in Outcomes After Cardiac Arrest
- Improvements in Defibrillation
- General AED Characteristics
- Defibrillation Waveform
- Fixed Versus Escalating Energy
- Impedance Compensation
- Defibrillation Guided by Waveform Analysis
- Challenge of Time to Defibrillation
- Lay Rescuer Programs to Reduce Time to Defibrillation in Public
- Home Defibrillation to Reduce Time to Defibrillation
- Mobile Phone-Based Systems to Reduce Time to Defibrillation
- Residential Response
- Mobile AEDs
- Strategies to Convert Prolonged VF
- Impact of Concurrent Resuscitation Interventions
- VF in Young Athletes
- Hemodynamically Guided Resuscitation
- Implantable Cardioverter-Defibrillators
- Wearable Cardioverter-Defibrillator
- Future Directions