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New Insights and Prospects of Cardiac Arrest
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New Insights and Prospects of Cardiac Arrest

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Emergency Medicine".

Deadline for manuscript submissions: closed (20 November 2024) | Viewed by 7532

Special Issue Editor

Dr. Christoph Sinning

E-Mail Website
Guest Editor
Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistraße 42, 20246 Hamburg, Germany
Interests: cardiology; clinical science; heart failure treatment; treatment of adults with congenital heart disease; cardiovascular imaging; device therapy with CRT; magnetic resonance imaging of the heart and its applications; cardiovascular imaging of heart rhythm disorders

Special Issue Information

Dear Colleagues,

In recent years, many exciting advancements have been made in the management of cardiac arrest.

Out-of-hospital cardiac arrest is still a leading cause of death (OHCA) despite the use of advanced emergency devices. Most adults could be saved from cardiac arrest with the early recognition of cardiac arrest, prompt effective shocks via defibrillation and a functional post-resuscitation care program. 

The treatment of cardiac arrest is a real challenge for cardiologists, intensivists, and emergency physicians. Much progress has been made during the last years both in understanding the underlying mechanisms and in developing new treatments, but work must still be conducted. The more we study this topic, the more we improve patients’ chances of survival.

This Special Issue aims to highlight the current knowledge regarding cardiac arrest and underline possible current practices and future perspectives on cardiac arrest.

In this Special Issue, original articles and reviews are welcome. We look forward to receiving your contributions.

Dr. Christoph Sinning
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiac arrest
  • cardiology
  • clinical science
  • heart disease
  • cardiovascular imaging

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (4 papers)

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Research

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14 pages, 1782 KiB  
Article
The Interaction Effect of Age, Initial Rhythm, and Location on Outcomes After Out-of-Hospital Cardiac Arrest: A Retrospective Cohort Study
by Łukasz Lewandowski, Aleksander Mickiewicz, Kamil Kędzierski, Paweł Wróblewski, Mariusz Koral, Grzegorz Kubielas, Jacek Smereka and Michał Czapla
J. Clin. Med. 2024, 13(21), 6426; https://doi.org/10.3390/jcm13216426 - 26 Oct 2024
Cited by 1 | Viewed by 1258
Abstract
Background: Out-of-hospital cardiac arrest (OHCA) is a critical global health challenge and a leading cause of mortality. This study investigates the combined effect of initial cardiac arrest rhythm, patient age, and location on the return of spontaneous circulation (ROSC) in OHCA patients. [...] Read more.
Background: Out-of-hospital cardiac arrest (OHCA) is a critical global health challenge and a leading cause of mortality. This study investigates the combined effect of initial cardiac arrest rhythm, patient age, and location on the return of spontaneous circulation (ROSC) in OHCA patients. Methods: This retrospective study analyzed medical records from the National Emergency Medical Service (EMS) in Poland between January 2021 and June 2022. Data from 33,636 patients with OHCA who received cardiopulmonary resuscitation (CPR) at the scene were included. Results: Public incidents were associated with higher ROSC rates (54.10% vs. 31.53%, p < 0.001). Initial shockable rhythms (VF/pVT) significantly increased the odds of ROSC (OR = 3.74, 95% CI 3.39–4.13, p < 0.001). Obesity decreased the odds of ROSC in at-home cases (OR = 0.85, 95% CI 0.73–0.99, p = 0.036) but had no significant effect in public cases. The effect of age on ROSC outcomes varied significantly depending on the location. In patients younger than 60 years, better ROSC outcomes were observed in at-home cases, while for those older than 60 years, the odds of ROSC were higher in public locations. Each additional year of age decreased the odds of ROSC by 1.62% in at-home incidents (p < 0.001) and by 0.40% in public incidents (p = 0.009). Sex differences were significant in public locations, with women having higher odds of ROSC compared to men (OR = 0.57, 95% CI 0.37–0.87, p = 0.009 for VF/pVT). Conclusions: The interaction between the location of OHCA, initial cardiac rhythm, and patient age significantly impacts ROSC outcomes. Public locations show higher ROSC rates, especially in cases with shockable rhythms (VF/pVT). Age modifies ROSC outcomes, with younger patients benefiting more at home, and older patients showing better outcomes in public places. Full article
(This article belongs to the Special Issue New Insights and Prospects of Cardiac Arrest)
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17 pages, 668 KiB  
Article
Cardiac Arrest Mortality and Disposition Patterns in United States Emergency Departments
by Kenneth M. Zabel, Mohammed A. Quazi, Katarina Leyba, Alexandra C. Millhuff, Mikel Madi, Wilfredo Henriquez Madrid, Aman Goyal, Muhammad Ibraiz Bilal, Amir H. Sohail, Shazib Sagheer and Abu Baker Sheikh
J. Clin. Med. 2024, 13(18), 5585; https://doi.org/10.3390/jcm13185585 - 20 Sep 2024
Cited by 4 | Viewed by 2063
Abstract
Background: Despite resuscitative efforts, cardiac arrest (CA) continues to result in high mortality and poor prognosis. However, a gap remains in understanding the comparative outcomes of efforts in emergency departments (ED) over recent years. This study evaluated patients with CA during ED [...] Read more.
Background: Despite resuscitative efforts, cardiac arrest (CA) continues to result in high mortality and poor prognosis. However, a gap remains in understanding the comparative outcomes of efforts in emergency departments (ED) over recent years. This study evaluated patients with CA during ED visits, with a particular focus on outcomes of mortality and transition of care. Methods: We conducted a retrospective cohort analysis using the National Emergency Department Sample (NEDS) database. The study population included patients aged 18 years or older who visited the ED between January 2016 and December 2020. Statistical analysis of patients and hospital characteristics included chi-squared tests for independence and multivariable logistic regression models to report the associations of factors with mortality in the ED and disposition from the ED. The primary outcome measured was mortality in the ED, and the secondary outcome included transition of care. Results: A total of 699,822,424 ED visits occurred between 2016 and 2020, with 1,414,060 (0.20%) CAs. The survival rate from CA ranged from 24.6% to 28.1%. In 2020, the rate of ED CA increased to 0.27%, with an inpatient mortality rate of 58.8%. There was no significant difference in mortality between sexes (p = 0.690). There was a trend for higher mortality in the ED among patients who were self-paid. Notably, the odds of transfer from the ED to other hospitals were significantly lower in minority groups. Conclusions: Our results showed significant disparities in ED mortality and patient disposition following cardiac arrest, highlighting the need for equitable healthcare resources and policies. Full article
(This article belongs to the Special Issue New Insights and Prospects of Cardiac Arrest)
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9 pages, 377 KiB  
Article
Frequency, Prognosis, and Clinical Features of Unexpected versus Expected Cardiac Arrest in the Emergency Department: A Retrospective Analysis
by Karolina Szaruta-Raflesz, Tomasz Łopaciński and Mariusz Siemiński
J. Clin. Med. 2024, 13(9), 2509; https://doi.org/10.3390/jcm13092509 - 24 Apr 2024
Cited by 1 | Viewed by 1098
Abstract
Background: Though out-of-hospital CA (OHCA) is widely reported, data on in-hospital CA (IHCA) and especially cardiac arrest (CA) in the emergency department (CAED) are scarce. This study aimed to determine the frequency, prevalence, and clinical features of unexpected CAED and compare the [...] Read more.
Background: Though out-of-hospital CA (OHCA) is widely reported, data on in-hospital CA (IHCA) and especially cardiac arrest (CA) in the emergency department (CAED) are scarce. This study aimed to determine the frequency, prevalence, and clinical features of unexpected CAED and compare the data with those of expected CAED. Methods: We defined unexpected CAED as CA occurring in patients in non-critical ED-care areas; classified as not requiring strict monitoring. This classification was the modified Japanese Triage and Acuity Scale and physician assessment. A retrospective analysis of cases from 2016 to 2018 was performed, in comparison to other patients experiencing CAED. Results: The 38 cases of unexpected CA in this study constituted 34.5% of CA diagnosed in the ED and 8.4% of all CA treated in the ED. This population did not differ significantly from other CAED regarding demographics, comorbidities, and survival rates. The commonest symptoms were dyspnoea, disorders of consciousness, generalised weakness, and chest pain. The commonest causes of death were acute myocardial infarction, malignant neoplasms with metastases, septic shock, pulmonary embolism, and heart failure. Conclusions: Unexpected CAED represents a group of potentially avoidable CA and deaths. These patients should be analysed, and ED management should include measures aimed at reducing their incidence. Full article
(This article belongs to the Special Issue New Insights and Prospects of Cardiac Arrest)
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Review

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14 pages, 285 KiB  
Review
Emerging Evidence in Out-of-Hospital Cardiac Arrest—A Critical Appraisal of the Cardiac Arrest Center
by Felix Memenga and Christoph Sinning
J. Clin. Med. 2024, 13(13), 3973; https://doi.org/10.3390/jcm13133973 - 7 Jul 2024
Cited by 1 | Viewed by 2574
Abstract
The morbidity and mortality of out-of-hospital cardiac arrest (OHCA) due to presumed cardiac causes have remained unwaveringly high over the last few decades. Less than 10% of patients survive until hospital discharge. Treatment of OHCA patients has traditionally relied on expert opinions. However, [...] Read more.
The morbidity and mortality of out-of-hospital cardiac arrest (OHCA) due to presumed cardiac causes have remained unwaveringly high over the last few decades. Less than 10% of patients survive until hospital discharge. Treatment of OHCA patients has traditionally relied on expert opinions. However, there is growing evidence on managing OHCA patients favorably during the prehospital phase, coronary and intensive care, and even beyond hospital discharge. To improve outcomes in OHCA, experts have proposed the establishment of cardiac arrest centers (CACs) as pivotal elements. CACs are expert facilities that pool resources and staff, provide infrastructure, treatment pathways, and networks to deliver comprehensive and guideline-recommended post-cardiac arrest care, as well as promote research. This review aims to address knowledge gaps in the 2020 consensus on CACs of major European medical associations, considering novel evidence on critical issues in both pre- and in-hospital OHCA management, such as the timing of coronary angiography and the use of extracorporeal cardiopulmonary resuscitation (eCPR). The goal is to harmonize new evidence with the concept of CACs. Full article
(This article belongs to the Special Issue New Insights and Prospects of Cardiac Arrest)
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