Author + information
- Received July 24, 2018
- Revision received August 28, 2018
- Accepted September 22, 2018
- Published online January 7, 2019.
- Sanjiv M. Narayan, MD, PhDa,∗ (, )@S_NarayanMD@Wanginnovate@Stanford,
- Paul J. Wang, MDa and
- James P. Daubert, MDb
- aDepartment of Medicine, Division of Cardiology, Stanford University, Stanford, California
- bDepartment of Medicine, Division of Cardiology, Duke University, Durham, North Carolina
- ↵∗Address for correspondence:
Dr. Sanjiv M. Narayan, Stanford University, 780 Welch Road, Suite CJ250F, Stanford, California 94305.
Sudden cardiac arrest (SCA) is one of the largest causes of mortality globally, with an out-of-hospital survival below 10% despite intense research. This document outlines challenges in addressing the epidemic of SCA, along the framework of respond, understand and predict, and prevent. Response could be improved by technology-assisted orchestration of community responder systems, access to automated external defibrillators, and innovations to match resuscitation resources to victims in place and time. Efforts to understand and predict SCA may be enhanced by refining taxonomy along phenotypical and pathophysiological “axes of risk,” extending beyond cardiovascular pathology to identify less heterogeneous cohorts, facilitated by open-data platforms and analytics including machine learning to integrate discoveries across disciplines. Prevention of SCA must integrate these concepts, recognizing that all members of society are stakeholders. Ultimately, solutions to the public health challenge of SCA will require greater awareness, societal debate and focused public policy.
- acute coronary syndrome
- cardiopulmonary resuscitation
- heart failure
- machine learning
- sudden cardiac arrest
This study is funded, in part, by grants to Dr. Narayan from the National Institutes of Health (HL83359, HL103800), and to Dr. Wang from the American Heart Association (PCORI-AHA DECIDE Research Network 18SFRN34120036). Dr. Narayan has received consulting fees/honoraria from Medtronic, Abbott, and TDK; has received grant support from the National Institutes for Health; and holds intellectual property rights with the University of California Regents, Stanford University. Dr. Daubert has received consulting fees/honoraria from Medtronic, St. Jude Medical, Boston Scientific, Sorin Group, Zoll, Gilead, Iowa Approach, and VytronUS; has received research grants from Boston Scientific, Biosense Webster, Medtronic, and Gilead Sciences; and has received fellowship support from Medtronic, Boston Scientific, St. Jude Medical, and Biosense Webster. Dr. Wang has reported that he has no relationships relevant to the contents of this paper to disclose.
Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin Fuster on JACC.org.
- Received July 24, 2018.
- Revision received August 28, 2018.
- Accepted September 22, 2018.
- 2019 American College of Cardiology Foundation
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