[Successful use of an AED following anterior myocardial infarction]

A participant of the annual Hamburg marathon collapses on the finish line. Medics at the scene find a conscious patient and prepare transport to the finish area medical center. During transport the patient becomes unconscious and pulseless. The medics immediately perform basic life support and cardiopulmonary resuscitation (CPR). An automated external defibrillator (AED) is attached and after analysis of the patient}s heart rhythm the patient is defibrillated twice. The ambulance service reach the scene with a delay. The emergency physician}s ECG shows ventricular fibrillation (VF) and two more defibrillations are delivered. Return of spontaneous circulation can be achieved. After stabilisation the patient is taken to hospital by ambulance. The ECG shows an anterior myocardial infarction and right bundle-branch block. The coronary angioplasty (PTCA) shows single-vessel disease with complete stenosis of the proximal part of the anterior interventricular branch. Revasucarisation is successful and a coronary stent is applied. The patient survives neurologically intact. This case report demonstrates the importance of readily available AED and specially trained medics. By immediately using the AED this patient was defibrillated before the ambulance service and emergency physician arrived at the scene. Spontaneous circulation was restored.