Sudden Cardiac Arrest Lost Time is Never Found Again- Dr Rohit Walia

डॉ. रोहित वालिया

9 Out Of 10 People Don’t Survive
Sudden Cardiac Arrest. Here’s
Why
Find out why this heart problem
is so deadly —and how you can
up your odds of surviving it.
What is Sudden Cardiac
Death ?
Death from cardiac arrest occurring within one hour of onset of
symptoms is referred to as Sudden Cardiac Death or SCD.
It is characterised by unexpected cardiovascular collapse from an
underlying cardiac cause. Interestingly, a large majority of SCDs happen
in people with no “known” pre-existing heart disease.
Often caused by abnormal heart rhythm. This aberrant rhythm is
ventricular fibrillation (VF). During VF heart stops pumping blood and
patient may stop breathing . No pulse may be detected . A shock to the
heart, called defibrillation stops VF, restores heart function.

Most common cause of death worldwide
Sudden Cardiac Death (SCD) from cardiac arrest is the most common
cause of death worldwide, accounting for more than 50 percent of all
cardiovascular deaths worldwide. The median survival from SCD is only   6.4%.
In the majority of patients who suffer SCD, the underlying mechanism is
Ventricular fibrillation. While effective cardio- pulmonary resuscitation
(CPR) can improve survival, the most effective treatment of ventricular
fibrillation is very early defibrillation.
In India because of lack of automated external defibrillator and public
awareness about recognition and resuscitation skills a victim faces certain death.

Recognition: When sudden cardiac arrest occurs, the victim   collapses,
becomes unresponsive to gentle shaking, stops normal breathing and after
two rescue breaths, still isn’t breathing normally, coughing or moving.

WHY THIS HAPPENS
This occurs due to sudden appearance of three possible rhythms in
heart
1- Ventricular fibrillation
2- Ventricular tachycardia
3- Asystole
WHAT IS VENTRICULAR FIBRILLATION ?
Ventricular Fibrillation (VF), the abnormal heart rhythm that most
often leads to
sudden cardiac arrest, is treatable. If the heart can be shocked
quickly with a defibrillator, a normal heart rhythm may be restored.
An automated external defibrillator (AED) is a portable device used
to administer an electric shock to the heart and restore the heart’s
normal rhythm during sudden cardiac arrest.
It is essential that defibrillation be administered immediately
following the cardiac arrest.
If the heart does not return to a regular rhythm within 5-7 minutes,
this fibrillation could
be fatal. If defibrillated within the first minute of collapse, the victim’s
chances for survival are close to 90 percent. For every minute that
defibrillation is delayed, survival decreases by 7 percent to 10
percent. If it is delayed by more than 10 minutes, the chance of
survival in adults is less than 5 percent.
LOST TIME IS NEVER FOUND AGAIN
The propensity to die suddenly relates to genetic or acquired
changes in the electrical or mechanical properties of the heart with
multiple transient factors that participate in triggering the fatal event.
50% of cardiac arrests occur in individuals without a known heart
disease, but most suffer from concealed ischemic heart disease or
genetic diseases, which could be diagnosed easily by proper
awareness and medical screening.
WHAT IS VENTRICULAR TACHYCARDIA?
Is a type of fast heartbeat that arises from abnormal electrical
activity in the lower chambers or ventricles of the heart. This rhythm
is more organized as compared to ventricular fibrillation but may
turn into ventricular fibrillation or itself lead to hemodynamic
instability and cardiac arrest. It is found initially in about 7 % of
people with cardiac arrest.
In diseased-scarred hearts and weak hearts with poor pumping
capacity, patients with coronary artery disease or certain electrical
problems of heart are associated with increased risk of ventricular
tachycardia.
This is an emergency and immediate defibrillation is needed in most
of cases.
WHAT IS A SYSTOLE?
Asystole is a state of no electrical activity from the heart and therefore no
blood.On ECG you will see a flat line .It is found in about 28 % of people
in cardiac arrest. Out of hospital survival rates are poorest in asystole and
less than 2 %.
What is Cardiopulmonary resuscitation
: CPR ?
It is an emergency life-saving measure. It is a combination of rescue
breathing & chest
compressions. It is done on unconscious/ non-breathing patient suffering
cardiac arrest. It supports heart pumping for short duration and allows
oxygen to reach brain. More effective when done as early as possible.
Buys time till help arrives.
How to Perform CPR the Right Way
• Before you do anything, call HELP/Ambulance first.

Then perform compression-only CPR.
• Kneel over the person, placing the heel of your hand on the middle of
his or her chest.
• Put your other hand on top.
• Then, push hard and fast, pumping down at 100 beats per minute,
which is just fast enough to keep circulating oxygen that’s already in
the patient’s body, basically doing the work of the heart.
Thousands of Indians die every day due to sudden cardiac arrest.
• Effective bystander CPR, provided immediately after cardiac arrest,
can double a victim’s chance of survival.
• CPR helps maintain vital blood flow to the heart and brain and
increases the amount of time that an electric shock from a
defibrillator can be effective.
• Approximately 95 percent of sudden cardiac arrest victims die before
reaching the hospital.
Death from sudden cardiac arrest is not inevitable. If more people
knew CPR, more lives could
be saved.
• Brain death starts to occur four to six minutes after someone
experiences cardiac arrest if no CPR and defibrillation occurs during
that time.
• If bystander CPR is not provided, a sudden cardiac arrest victim’s
chances of survival fall 7 percent to 10 percent for every minute of
delay until defibrillation. Few attempts at resuscitation are successful if CPR and defibrillation are not provided within minutes of collapse

Dr Rohit Walia
Founder Chairman – Arrhythmia Support Network
Intervention Cardiologist & Electrophysiologist & Structural Heart
Specialist
▪ Founder Chairman India’s First Arrhythmia Support Network
▪ Ex HOD & Founder Cardiology Department AIIMS Bathinda
▪ Ex In charge Cardiac Electrophysiology & Heart Failure Division AIIMS
Rishikesh
MD(Med), DNB (Med), DM(Cardiology)
▪ Post-Doctoral Fellowship: Electrophysiology & Devices
▪ Post-Doctoral Fellowship: Advance Electrophysiology (Atrial Fibrillation
& Ventricular Arrhythmia Ablation) (Taiwan, USA, Germany)
▪ Fellowship – Intervention Cardiology & Structural Heart (Germany,
Switzerland, USA)
▪ Post Graduate Diploma in Hospital administration, Health Economics &
Health policy
Associate Professor
Department of Cardiology
Christian Medical College Ludhiana, Punjab, India
Mobile: +918800492549
Email: drrohitwaliacardiology@gmail.com, pulseislife1@gmail.com
https://arrhythmiasupport.com
The noblest question in the world is, ‘What good may I do in it?

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