Sudden cardiac death: a retrospective and prospective study

Area of Science:

• Cardiology
• Emergency Medicine
• Public Health

Background:

• Mobile coronary care units (MCCU) have facilitated the study of patients experiencing sudden cardiac death (SCD).
• Advanced emergency medical technicians (EMT-A) play a crucial role in the initial management of SCD events.
• Understanding outcomes for resuscitated SCD patients is vital for improving pre-hospital care.

Purpose of the Study:

• To retrospectively and prospectively analyze outcomes of patients resuscitated from sudden cardiac death (SCD) by mobile coronary care units (MCCU).
• To identify factors influencing survival and long-term prognosis in ventricular fibrillation (VF) survivors.
• To evaluate the New York Heart Association (NYHA) functional classification in SCD survivors.

Main Methods:

• Retrospective and prospective analysis of 48 cases of SCD successfully resuscitated by EMT-A.
• Assessment of myocardial infarction presence, NYHA class, and long-term survival.
• Documentation of rescue response times and interventions, including intracardiac medications and sodium bicarbonate administration.

Main Results:

• 23% of patients with ventricular fibrillation (VF) survived; 80% of survivors were NYHA class I or II, resuming previous lifestyles.
• Only 32% of resuscitated SCD patients had a myocardial infarction.
• All NYHA class IV survivors with severe congestive heart failure died within 45 days; class II survivors were limited by angina.

Conclusions:

• Early intervention by MCCUs and EMT-A can lead to successful resuscitation from SCD, particularly in VF cases.
• NYHA functional class is a significant prognostic indicator, with higher classes associated with poor long-term survival.
• While intracardiac medications were safely administered, empirical sodium bicarbonate use showed poor correlation with blood gas levels.