Background and Objectives: Automated external defibrillator (AED) is known to improve survival of sudden cardiac death (SCD) patients, and was posted on public places from this year in Korea. We hypothesized that AED reduces neurologic damage (ND) and improves clinical outcome in patients with out of hospital aborted SCD (ASCD) in Korea.
Subjectives and Methods: We retrospectively reviewed 17 patients with ASCD (male 88.2%, 54±17 years old, ventricular tachycardia (VT)/fibrillation (VF) 100.0%), and classified them as ASCD successfully defibrillated by AED (AED-S; n=6), ASCD with intractable arrhythmia not defibrillated by AED (AED-F; n=11). We evaluated the degree of ND at 1 week by ASCD-ND grade (0, no ND; 1, independent daily activity (DA); 2, partially dependent DA; 3, entirely dependent DA), and rates of survival discharge and 6 month survival.
Results:
1. Initial rhythm was VF in 100% of AED-S and AED-F. Time form witnessed arrest to return of spontaneous circulation was shorter in AED-S (12.3±4.1 min) than AED-F (33.6±10.7 min, p<0.001, p=0.034).
2. ASCD-ND grades were 0.30.8 in AED-S and 2.60.9 in AED-F, respectively (p<0.001). In AED-S, 16.7% (1/6) remains retrograde amnesia, but other patients were neurologically free at discharge. In contrast, 63.6% (7/11) were vegetate state at discharge in AED-F. The rates of survival discharge and 6 month survival were 100% vs. 63.6% (p=0.240) and 100% vs. 40% (p=0.04) in AED-S and AED-F, respectively.
Conclusion :
Successful defibrillation by AED reduces ND and improves the rates of survival discharge and 6 month survival as compared with unsuccessfully defibrillation in Korean patients who suffered from ASCD. AED definitely saves more lives, also it may also improve the quality of life of victims and reduce the socioeconomic burden.
Key words : Automated external defibrillator, sudden cardiac death, survival, neurologic damage
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