Circadian variation pattern of sudden cardiac arrest occurred in Chinese community
Peng-Cheng Yao1, Mo-Han Li1, Mu Chen1
1Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
Sudden cardiac arrest (SCA) in China shows a clear daily pattern, peaking in the morning hours. This highlights the need for increased resources during these critical times for better resuscitation outcomes.
Area of Science:
- Cardiology
- Circadian Rhythms
- Public Health
Background:
- The daily variation of sudden cardiac arrest (SCA) in Chinese communities is not well understood.
- This study investigates the circadian patterns of SCA within the Chinese population.
Purpose of the Study:
- To analyze the circadian variation of SCA in the Chinese community.
- To stratify SCA events by initial shockable versus non-shockable rhythms.
Main Methods:
- Analysis of 10,210 SCA cases from 2018-2022 using a remote ECG diagnosis system.
- Stratification of SCA by initial rhythm: ventricular tachycardia/fibrillation (shockable) vs. asystole/pulseless electrical activity (non-shockable).
Main Results:
- SCA peaked between 08:00-11:59 (30.1%) and was lowest from 00:00-03:59 (7.5%).
- Both shockable and non-shockable SCA events were most frequent in the morning (29.0% and 36.4%, respectively).
- The risk of shockable SCA was lower in the early morning (00:00-07:59) but higher in late morning (08:00-11:59) compared to non-shockable events.
Conclusions:
- A distinct circadian rhythm exists for SCA in the Chinese community, irrespective of the initial rhythm.
- Findings suggest increased focus and resources for first-aid and resuscitation during morning hours in Chinese communities.
Background:
The circadian variation pattern of sudden cardiac arrest (SCA) occurred in Chinese community including both community healthcare centres and primary hospitals remains unknown. This study analysed the circadian variation of SCA in the Chinese community.
Methods:
Data between 2018 and 2022 from the remote ECG diagnosis system of Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine were analysed to examine the circadian rhythm of SCA, stratified by initial shockable (ventricular tachycardia or ventricular fibrillation) versus non-shockable (asystole or pulseless electrical activity) rhythm.
Results:
Among 10 210 cases of SCA, major cases (8736, 85.6%) were non-shockable and 1474 (14.4%) cases were shockable. The circadian rhythm of SCA was as follows: peak time was from 08:00 to 11:59 (30.1%), while deep valley was from 00:00 to 03:59 (7.5%). The proportions of events by non-shockable and shockable events were similar and both reached their peak from 08:00 to 11:59, with a percentage of 29.0% and 36.4%, respectively. Multivariable analysis showed that the relative risk of shockable compared with non-shockable arrests was lower between 00:00 and 03:59 (adjusted OR (aOR): 0.72, 95% CI: 0.54 to 0.97, p=0.028) and 04:00 to 07:59 (aOR: 0.60, 95% CI: 0.46 to 0.79, p<0.001), but higher between 08:00 and 11:59 (aOR: 1.34, 95% CI: 1.09 to 1.64, p=0.005).
Conclusions:
In Chinese community, there is a distinct circadian rhythm of SCA, regardless of initial rhythms. Our findings may be helpful in decision-making, in that more attention and manpower should be placed on the morning hours of first-aid and resuscitation management in Chinese community.
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