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Related Experiment Video

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Standardized Model of Ventricular Fibrillation and Advanced Cardiac Life Support in Swine

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Published on: January 30, 2020

Initial cardiac rhythm and rhythm conversion recorded by public access defibrillators.

Niels Saaby Hald¹, Thomas Kirk Hartmann², Niels Thomas Sørensen²

¹Emergency Medical Services, North Denmark Region, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Denmark; Center for Prehospital and Emergency Care Research, Danish Centre for Health Services Research, Aalborg University Hospital and Department of Clinical Medicine, Aalborg University, Denmark.

|September 25, 2025

Summary

Public access defibrillators (PADs) reveal initial cardiac rhythms in out-of-hospital cardiac arrest (OHCA) cases. An initial shockable rhythm significantly improves survival rates, while non-shockable rhythms indicate a poor prognosis even with intervention.

Keywords:

Automated external defibrillator Bystander Out-of-hospital cardiac arrest Public access defibrillator Resuscitation

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Published on: April 26, 2015

Area of Science:

Cardiology
Emergency Medicine
Public Health

Background:

Out-of-hospital cardiac arrest (OHCA) research often overlooks pre-hospital events.
Public access defibrillators (PADs) capture crucial early cardiac rhythm data during bystander resuscitation.
This study leverages PAD data to analyze cardiac rhythms in OHCA cases.

Purpose of the Study:

To investigate the prognostic value of cardiac rhythms recorded by PADs in OHCA.
To compare survival outcomes based on initial shockable versus non-shockable rhythms.
To assess the impact of rhythm conversion on OHCA survival.

Main Methods:

Data from PADs (2016-2021) were integrated with the Danish Cardiac Arrest Registry.
PAD-recorded cardiac rhythms underwent manual review and classification (shockable vs. non-shockable).
Multivariable logistic regression was employed to analyze survival rates.

Main Results:

Out of 3179 OHCA cases, 559 had PAD data; 26% showed an initial shockable rhythm.
The shockable rhythm group had higher survival rates (40%) and return of spontaneous circulation (ROSC) (61%) compared to the non-shockable group (5% survival, 17% ROSC).
Rhythm conversion did not significantly improve survival, and patients with >5 consecutive shockable rhythms did not survive.

Conclusions:

The initial cardiac rhythm recorded by PADs is a critical prognostic indicator in OHCA.
Survival remains low for OHCA patients with non-shockable rhythms, irrespective of rhythm conversion.
PAD data integration can enhance clinical decision-making for OHCA management.