Redefining heartcare with advanced technologies: Managing sudden cardiac arrest



Article By: Dr. Subhash Chandra

Managing Sudden Cardiac Arrest with Technologies That Matter



Putting patients with comorbidities at an added risk of contracting coronavirus, the pandemic taught us an important lesson— the need to address the burden of non-communicable diseases. In fact, a study has revealed that people infected with COVID-19 are at a higher risk of dying in case of a cardiac arrest. The finding is particularly alarming for a country like India where an estimated seven lakh people are diagnosed with sudden cardiac arrest. Sudden cardiac arrest can be lethal, if not treated immediately. However, timely medical intervention using the latest technological advances can go a long way in improving patient outcomes.

Sudden cardiac arrest occurs when the heart loses its ability to function properly abruptly, regardless of any history of heart disease.

Sudden cardiac arrest happens due to abnormal heart rhythm (arrhythmia) which is a result of inefficient functioning of the heart’s electrical system. The rate and rhythm of the heartbeat are controlled by the heart’s electrical system. At times, the heart can beat too fast, too slowly or irregularly. Mostly these arrhythmias are harmless and brief, however, at times, some can lead to sudden cardiac arrest. The most common heart rhythm at the time of cardiac arrest is an arrhythmia in the lower chamber of the heart. Erratic and rapid electrical impulses cause the ventricles to quiver instead of pumping necessary blood to the bod. Reduced blood to the brain causes unconsciousness when sudden cardiac arrest occurs. Brain damage occurs if the heart rhythm does not return to normal, which can also result in death. Common signs of sudden cardiac arrest include unexplained wheezing, loss of consciousness, chest discomfort, shortness of breath, weakness, and fast beating, fluttering, or pounding heart.

Managing Sudden Cardiac Arrest with Technologies That Matter

Sudden cardiac arrest can affect people with no known heart disease. It is also imperative to note that a life-threatening arrhythmia usually develops in a person with a pre-existing heart condition. These conditions include heart attack, coronary artery disease (CAD), enlarged heart known as cardiomyopathy, congenital heart defect, valvular heart disease, and electrical problems in the heart.

Minimally invasive alternatives such as subcutaneous implantable cardioverter-defibrillator (S-ICD) are used to treat patients with increased complications. The procedure detects abnormal heartbeats and delivers electrical pulses to restore normal ones when needed.

The defibrillator is implanted beneath the skin and the battery is arranged under the armpit. On the top of the breastbone near the heart, the electrode is placed, and an electric shock is delivered when it detects any abnormal heart arrhythmia. What increased the chance of survival is that the Implantable defibrillators give a treatment response in less than 30 seconds. As S-ICD uses a beneath the skin or subcutaneous electrode, it eliminated the need of connecting the leads directly to the heart muscle. The biggest benefit of the procedure is that since the heart and blood vessels are untouched, it reduces the risk of injury. The procedure primarily benefits the patients who are on dialysis as they require blood vessels for their treatment. The procedure leaves no scar, reduces hospital stay, and gives patients an improved quality of life.

For the treatment of patients with ventricular arrhythmias and the prevention of sudden cardiac death, the 2017 American Heart Association (AHA), the American College of Cardiology (ACC) and the Heart Rhythm Society (HRS) recommend the use of S-ICD.

After a person has survived sudden cardiac arrest, the doctor recommends some tests to prevent any similar episodes in the future. These include electrocardiogram, blood tests, and imaging tests such as echocardiogram and x-ray. As per European Society of Cardiology, out-of-hospital cardiac arrest is the third leading cause of death globally.

The best preventive measures of sudden cardiac arrest are the ones that involve home based remedies and certain lifestyle changes. A person must maintain a healthy weight, quit smoking, drink alcohol in moderation, stay physically active and manage stress to keep blood pressure level under control and eat a diet prescribed by a dietician as per the medical condition. It is also critical to go for regular check-ups and spread awareness about the latest treatment options available in case of emergency.



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