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Balaji S, Atkins DL, Berger S, Etheridge SP, Shah MJ. The Case for Home AED in Children, Adolescents, and Young Adults Not Meeting Criteria for ICD. JACC Clin Electrophysiol 2022; 8:1165-1172. [PMID: 36137726 DOI: 10.1016/j.jacep.2022.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 12/01/2022]
Abstract
Children, adolescents, and young adults with conditions such as cardiomyopathies and channelopathies are at higher risk of sudden cardiac death caused by lethal arrhythmias, especially ventricular fibrillation. Timely defibrillation saves lives. Patients thought to be at significantly high risk of sudden death typically undergo placement of an implantable cardioverter-defibrillator. Patients thought to be at lower risk are typically followed medically but do not undergo implantable cardioverter-defibrillator placement. However, low risk does not equal no risk. Compared with the general population, many of these patients are at significantly higher risk for lethal arrhythmias. We make the case that such individuals and families will benefit from having an at-home automatic external defibrillator. Used in conjunction with conventional measures such as training on cardiopulmonary resuscitation, an at-home automatic external defibrillator could lead to significantly shortened time to defibrillation with better overall and neurological survival. We recommend that the cost of such home automatic external defibrillators should be covered by medical insurance.
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Affiliation(s)
- Seshadri Balaji
- Department of Pediatrics, Oregon Health and Science University, Portland Oregon, USA.
| | - Dianne L Atkins
- Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | | | | | - Maully J Shah
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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Marijon E, Bougouin W, Karam N, Beganton F, Lamhaut L, Perier MC, Benameur N, Tafflet M, Beal G, Hagege A, Le Heuzey JY, Desnos M, Spaulding C, Carré F, Dumas F, Celermajer DS, Cariou A, Jouven X. Survival from sports-related sudden cardiac arrest: In sports facilities versus outside of sports facilities. Am Heart J 2015; 170:339-345.e1. [PMID: 26299232 DOI: 10.1016/j.ahj.2015.03.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 03/30/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND We sought to evaluate frequency, characteristics, and outcomes of sudden cardiac arrest (SCA) during sports activities according to the location of occurrence (in sports facilities vs those occurring outside of sports facilities). METHODS AND RESULTS This is an observational 5-year prospective national French survey of subjects 10 to 75 years old presenting with SCA during sports (2005-2010), in 60 French administrative regions (covering a population of 35 million people). Of the 820 SCA during sports, 426 SCAs (52%) occurred in sports facilities. Overall, a substantially higher survival rate at hospital discharge was observed among SCA in sports facilities (22.8%, 95% CI 18.8-26.8) compared to those occurring outside (8.0%, 95% CI 5.3-10.7) (P < .0001). Patients with SCA in sports facilities were younger (42.1 vs 51.3 years, P < .0001) and less frequently had known cardiovascular diseases (P < .0001). The events were more often witnessed (99.8% vs 84.9%, 0.0001), and bystander cardiopulmonary resuscitation was more frequently initiated (35.4% vs 25.9%, P = .003). Delays of intervention were significantly shorter when SCA occurred in sports facilities (9.3 vs 13.6, P=0.03), and the proportion of initially shockable rhythm was higher (58.8% vs 33.1%, P < .0001). Better survival in sports facilities was mainly explained by concomitant circumstances of occurrence (adjusted odds ratio 1.48, 95% CI 0.88-2.49, P = .134). CONCLUSIONS Sports-related SCA is not a homogeneous entity. The 3-fold higher survival rate reported among sports-related SCA is mainly due to cases that occur in sports facilities, whereas SCA during sports occurring outside of sports facilities has the usual very low rate of survival.
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Affiliation(s)
- Eloi Marijon
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France; Cardiology Department, Georges Pompidou European Hospital, Paris, France
| | - Wulfran Bougouin
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France; Intensive Care Unit, Cochin Hospital, Paris, France
| | - Nicole Karam
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France; Cardiology Department, Georges Pompidou European Hospital, Paris, France
| | - Frankie Beganton
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France
| | - Lionel Lamhaut
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France; Intensive Care Unit and SAMU 75, Necker Enfants-Malades Hospital, Paris, France
| | - Marie-Cécile Perier
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France
| | - Nordine Benameur
- Lille 2 University Hospital, University of Lille, Emergency Department and SAMU 59, Lille, France
| | - Muriel Tafflet
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France
| | - Guillaume Beal
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France
| | - Albert Hagege
- Paris Descartes University, Paris, France; Cardiology Department, Georges Pompidou European Hospital, Paris, France
| | - Jean-Yves Le Heuzey
- Paris Descartes University, Paris, France; Cardiology Department, Georges Pompidou European Hospital, Paris, France
| | - Michel Desnos
- Paris Descartes University, Paris, France; Cardiology Department, Georges Pompidou European Hospital, Paris, France
| | - Christian Spaulding
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France; Cardiology Department, Georges Pompidou European Hospital, Paris, France
| | - Francois Carré
- Rennes 1 University, Pontchaillou Hospital, INSERM UMR, Rennes, France
| | - Florence Dumas
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France
| | | | - Alain Cariou
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France
| | - Xavier Jouven
- Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France; Cardiology Department, Georges Pompidou European Hospital, Paris, France.
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de Ornelas Maia ACC, Soares-Filho G, Pereira V, Nardi AE, Silva AC. Psychiatric disorders and quality of life in patients with implantable cardioverter defibrillators: a systematic review. Prim Care Companion CNS Disord 2013; 15:PCC.12r01456. [PMID: 23930235 PMCID: PMC3733528 DOI: 10.4088/pcc.12r01456] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 01/16/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To systematically review the literature with regard to psychiatric disorders and quality of life in patients with an implantable cardioverter defibrillator. DATA SOURCES Research was conducted in 3 databases (ISI Web of Science, PubMed, and PsycINFO) using the terms implantable, cardioverter, defibrillator, quality of life, psych *, anxiety, and depression. STUDY SELECTION The search yielded 1,399 references. Non-English and repeated references were excluded. After abstract analysis, 42 references were recovered for full-text reading, and 25 articles were selected for this review. DATA EXTRACTION Research took place in April 2012, and no time restriction was placed on any of the database searches. Review or theoretical articles were excluded, and only clinical trials and epidemiologic studies were selected for this review. RESULTS A systematic review of the literature revealed mostly observational prospective cohort studies followed by cross-sectional observational studies and randomized clinical trials. Few studies included in the review were observational retrospective cohort or case-control studies. There are prominent signs and symptoms of anxiety and depression in patients with an implantable cardioverter defibrillator. Disorders include phobic anxiety, posttraumatic stress disorder, panic disorder, somatoform disorder, agoraphobia, and depression. Quality of life in the physical, social, and psychological domains is affected and is related to the intensity and the frequency of the device's electrical discharge. CONCLUSIONS Work regarding psychiatric comorbidity in patients with an implantable cardioverter defibrillator has shown that anxiety and depression are common. The patients and their families should be informed by their doctors that the presence of the device minimizes risk of sudden death and allows them to have a normal life.
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Affiliation(s)
- Ana Claudia C de Ornelas Maia
- Laboratory of Panic and Respiration, Institute of Psychiatry (Drs Soares-Filho and Silva and Mss Ornelas Maia and Pereira) and National Institute for Science and Technology, Translational Medicine (Drs Nardi and Silva), Federal University of Rio de Janeiro; and National Institute for Science and Technology, Translational Medicine, Federal University Fluminense (Dr Silva), Rio de Janeiro, Brazil
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