Bystander CPR may improve survival in exercise-related sudden cardiac arrest: BJSM

Canada: A new study shows that exercise-related sudden cardiac arrest (SCA) is more common in men and is usually accompanied by a shockable ventricular arrhythmia, emphasizing the significance of quick access to defibrillation.Therefore Bystander CPR may play and important role in improving survival in exercise-related sudden cardiac arrest

This study was conducted by Nicholas Grubic & team and the results were published in the British Journal of Sports Medicine on 1st December 2021.

This study was a systematic review with the goal of evaluating bystander interventions and survival rates following exercise-related SCA. From the beginning of the study through November/December 2020, MEDLINE, EMBASE, PubMed, CINAHL, SPORTDiscus, Cochrane Library, and grey literature sources were searched.

Observational studies examining a population of exercise-related SCA (out-of-hospital cardiac arrests that occurred during exercise or within 1 hour of cessation of activity) where bystander cardiopulmonary resuscitation (CPR) and/or automated external defibrillator (AED) use were reported, as well as survival outcomes. The median (IQR) percentage of bystander CPR and bystander AED usage, as well as the median (IQR) rate of survival to hospital discharge, were determined across all included studies.

This evaluation includes 29 studies with a median study period of 78.7 months and a median sample size of 91 participants. The majority of exercise-related SCA patients were middle-aged (median: 51, IQR: 39-56 years) and presented with a shockable arrest rhythm. Bystander CPR was used in a median of 71 percent of arrests, whereas bystander AED was used in a median of 31 percent of arrests. The median survival rate was 32 percent of the 19 trials that reported survival to a hospital release. Bystander CPR and AED usage were linked to survival following exercise-related SCA in studies that looked at the association between bystander interventions and survival outcomes.

In conclusion, bystander CPR was given to 71% of exercise-related SCA patients, and 31% had an AED applied by a bystander. Exercise-related SCA had a median survival rate of 32% to a hospital release. Exercise-related SCA requires more efforts to encourage early detection and quick bystander intervention.

Reference:

Grubic N, Hill B, Phelan D, Baggish A, Dorian P, Johri AM. Bystander interventions and survival after exercise-related sudden cardiac arrest: a systematic review. Br J Sports Med. 2021 Dec 1:bjsports-2021-104623. doi:10.1136/bjsports-2021-104623. Epub ahead of print. PMID: 34853034.