Survival after ventricular fibrillation cardiac arrest in the sao paulo metropolitan subway system: First successful targeted automated external defibrillator (AED) program in latin america

Renan Gianotto-Oliveira, Maria Margarita Gonzalez, Caio Brito Vianna, Maurício Monteiro Alves, Sergio Timerman, Roberto Kalil Filho, Karl B Kern

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background--Targeted automated external defibrillator (AED) programs have improved survival rates among patients who have an out-of-hospital cardiac arrest (OHCA) in US airports, as well as European and Japanese railways. The Sao Paulo (Brazil) Metro subway carries 4.5 million people per day. A targeted AED program was begun in the Sao Paulo Metro with the objective to improve survival from cardiac arrest. Methods and Results--A prospective, longitudinal, observational study of all cardiac arrests in the Sao Paulo Metro was performed from September 2006 through November 2012. This study focused on cardiac arrest by ventricular arrhythmias, and the primary endpoint was survival to hospital discharge with minimal neurological impairment. A total of 62 patients had an initial cardiac rhythm of ventricular fibrillation. Because no data on cardiac arrest treatment or outcomes existed before beginning this project, the first 16 months of the implementation was used as the initial experience and compared with the subsequent 5 years of full operation. Return of spontaneous circulation was not different between the initial 16 months and the subsequent 5 years (6 of 8 [75%] vs. 39 of 54 [72%]; P=0.88). However, survival to discharge was significantly different once the full program was instituted (0 of 8 vs. 23 of 54 [43%]; P=0.001). Conclusions--Implementation of a targeted AED program in the Sao Paulo Metro subway system saved lives. A short interval between arrest and defibrillation was key for good long-term, neurologically intact survival. These results support strategic expansion of targeted AED programs in other large Latin American cities.

Original languageEnglish (US)
Article numbere002185
JournalJournal of the American Heart Association
Volume4
Issue number10
DOIs
StatePublished - 2015

Fingerprint

Railroads
Defibrillators
Latin America
Ventricular Fibrillation
Heart Arrest
Survival
Airports
Out-of-Hospital Cardiac Arrest
Observational Studies
Brazil
Longitudinal Studies
Cardiac Arrhythmias
Survival Rate

Keywords

  • Automatic external defibrillation
  • cardiopulmonary resuscitation
  • Ventricular fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Survival after ventricular fibrillation cardiac arrest in the sao paulo metropolitan subway system : First successful targeted automated external defibrillator (AED) program in latin america. / Gianotto-Oliveira, Renan; Gonzalez, Maria Margarita; Vianna, Caio Brito; Alves, Maurício Monteiro; Timerman, Sergio; Filho, Roberto Kalil; Kern, Karl B.

In: Journal of the American Heart Association, Vol. 4, No. 10, e002185, 2015.

Research output: Contribution to journalArticle

Gianotto-Oliveira, Renan ; Gonzalez, Maria Margarita ; Vianna, Caio Brito ; Alves, Maurício Monteiro ; Timerman, Sergio ; Filho, Roberto Kalil ; Kern, Karl B. / Survival after ventricular fibrillation cardiac arrest in the sao paulo metropolitan subway system : First successful targeted automated external defibrillator (AED) program in latin america. In: Journal of the American Heart Association. 2015 ; Vol. 4, No. 10.
@article{dbd5f265c6b8477cadc0a09edb2a72be,
title = "Survival after ventricular fibrillation cardiac arrest in the sao paulo metropolitan subway system: First successful targeted automated external defibrillator (AED) program in latin america",
abstract = "Background--Targeted automated external defibrillator (AED) programs have improved survival rates among patients who have an out-of-hospital cardiac arrest (OHCA) in US airports, as well as European and Japanese railways. The Sao Paulo (Brazil) Metro subway carries 4.5 million people per day. A targeted AED program was begun in the Sao Paulo Metro with the objective to improve survival from cardiac arrest. Methods and Results--A prospective, longitudinal, observational study of all cardiac arrests in the Sao Paulo Metro was performed from September 2006 through November 2012. This study focused on cardiac arrest by ventricular arrhythmias, and the primary endpoint was survival to hospital discharge with minimal neurological impairment. A total of 62 patients had an initial cardiac rhythm of ventricular fibrillation. Because no data on cardiac arrest treatment or outcomes existed before beginning this project, the first 16 months of the implementation was used as the initial experience and compared with the subsequent 5 years of full operation. Return of spontaneous circulation was not different between the initial 16 months and the subsequent 5 years (6 of 8 [75{\%}] vs. 39 of 54 [72{\%}]; P=0.88). However, survival to discharge was significantly different once the full program was instituted (0 of 8 vs. 23 of 54 [43{\%}]; P=0.001). Conclusions--Implementation of a targeted AED program in the Sao Paulo Metro subway system saved lives. A short interval between arrest and defibrillation was key for good long-term, neurologically intact survival. These results support strategic expansion of targeted AED programs in other large Latin American cities.",
keywords = "Automatic external defibrillation, cardiopulmonary resuscitation, Ventricular fibrillation",
author = "Renan Gianotto-Oliveira and Gonzalez, {Maria Margarita} and Vianna, {Caio Brito} and Alves, {Maur{\'i}cio Monteiro} and Sergio Timerman and Filho, {Roberto Kalil} and Kern, {Karl B}",
year = "2015",
doi = "10.1161/JAHA.115.002185",
language = "English (US)",
volume = "4",
journal = "Journal of the American Heart Association",
issn = "2047-9980",
publisher = "Wiley-Blackwell",
number = "10",

}

TY - JOUR

T1 - Survival after ventricular fibrillation cardiac arrest in the sao paulo metropolitan subway system

T2 - First successful targeted automated external defibrillator (AED) program in latin america

AU - Gianotto-Oliveira, Renan

AU - Gonzalez, Maria Margarita

AU - Vianna, Caio Brito

AU - Alves, Maurício Monteiro

AU - Timerman, Sergio

AU - Filho, Roberto Kalil

AU - Kern, Karl B

PY - 2015

Y1 - 2015

N2 - Background--Targeted automated external defibrillator (AED) programs have improved survival rates among patients who have an out-of-hospital cardiac arrest (OHCA) in US airports, as well as European and Japanese railways. The Sao Paulo (Brazil) Metro subway carries 4.5 million people per day. A targeted AED program was begun in the Sao Paulo Metro with the objective to improve survival from cardiac arrest. Methods and Results--A prospective, longitudinal, observational study of all cardiac arrests in the Sao Paulo Metro was performed from September 2006 through November 2012. This study focused on cardiac arrest by ventricular arrhythmias, and the primary endpoint was survival to hospital discharge with minimal neurological impairment. A total of 62 patients had an initial cardiac rhythm of ventricular fibrillation. Because no data on cardiac arrest treatment or outcomes existed before beginning this project, the first 16 months of the implementation was used as the initial experience and compared with the subsequent 5 years of full operation. Return of spontaneous circulation was not different between the initial 16 months and the subsequent 5 years (6 of 8 [75%] vs. 39 of 54 [72%]; P=0.88). However, survival to discharge was significantly different once the full program was instituted (0 of 8 vs. 23 of 54 [43%]; P=0.001). Conclusions--Implementation of a targeted AED program in the Sao Paulo Metro subway system saved lives. A short interval between arrest and defibrillation was key for good long-term, neurologically intact survival. These results support strategic expansion of targeted AED programs in other large Latin American cities.

AB - Background--Targeted automated external defibrillator (AED) programs have improved survival rates among patients who have an out-of-hospital cardiac arrest (OHCA) in US airports, as well as European and Japanese railways. The Sao Paulo (Brazil) Metro subway carries 4.5 million people per day. A targeted AED program was begun in the Sao Paulo Metro with the objective to improve survival from cardiac arrest. Methods and Results--A prospective, longitudinal, observational study of all cardiac arrests in the Sao Paulo Metro was performed from September 2006 through November 2012. This study focused on cardiac arrest by ventricular arrhythmias, and the primary endpoint was survival to hospital discharge with minimal neurological impairment. A total of 62 patients had an initial cardiac rhythm of ventricular fibrillation. Because no data on cardiac arrest treatment or outcomes existed before beginning this project, the first 16 months of the implementation was used as the initial experience and compared with the subsequent 5 years of full operation. Return of spontaneous circulation was not different between the initial 16 months and the subsequent 5 years (6 of 8 [75%] vs. 39 of 54 [72%]; P=0.88). However, survival to discharge was significantly different once the full program was instituted (0 of 8 vs. 23 of 54 [43%]; P=0.001). Conclusions--Implementation of a targeted AED program in the Sao Paulo Metro subway system saved lives. A short interval between arrest and defibrillation was key for good long-term, neurologically intact survival. These results support strategic expansion of targeted AED programs in other large Latin American cities.

KW - Automatic external defibrillation

KW - cardiopulmonary resuscitation

KW - Ventricular fibrillation

UR - http://www.scopus.com/inward/record.url?scp=85006208120&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85006208120&partnerID=8YFLogxK

U2 - 10.1161/JAHA.115.002185

DO - 10.1161/JAHA.115.002185

M3 - Article

C2 - 26452987

AN - SCOPUS:85006208120

VL - 4

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

IS - 10

M1 - e002185

ER -