Circadian Rhythms in Sudden Cardiac Arrest: A Review

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Dieu-My T Tran, Barbara St Pierre Schneider, Graham R McGinnis

    Nursing Research
    |April 22, 2021
    PubMed

    Insights

    Sudden cardiac arrest (SCA) incidence and survival rates vary by time of day, with peaks in the morning and afternoon. Survival is lowest in the early morning hours, suggesting circadian rhythm influences SCA outcomes.

    Area of Science:

    • Cardiology
    • Chronobiology
    • Public Health

    Background:

    • Sudden cardiac arrest (SCA) remains a significant public health concern with high mortality rates.
    • Survivors of SCA face risks of organ damage, highlighting the need to understand contributing factors.
    • Time of day is a potential factor influencing SCA occurrence and survival outcomes.

    Purpose of the Study:

    • To review the impact of time of day on SCA incidence and survival over 30 years.
    • To investigate how age, sex, and location modulate the timing of SCA.
    • To synthesize current research on chronobiology and cardiac arrest.

    Main Methods:

    • Systematic review guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) criteria.
    • Searched four major databases: PubMed, Cochrane Libraries, Scopus, and CINAHL.
    • Included 48 articles analyzing time of day in relation to cardiac arrest.

    Main Results:

    • Identified a bimodal distribution of SCA, with peaks in the morning and afternoon.
    • SCA timing varied by age (higher in older adults), sex (more frequent in males), and location (out-of-hospital vs. in-hospital).
    • Lowest survival rates following SCA occurred between midnight and 6 a.m.

    Conclusions:

    • Circadian rhythms likely influence the time-dependent patterns of SCA incidence and survival.
    • Further nursing research is recommended to explore circadian rhythm's role in cardiovascular health, especially in older adults.
    Abstract

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