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Cardiovascular medicine
Demographic and temporal trends in out of hospital sudden cardiac death in Belfast
  1. M J Moore1,
  2. B M Glover1,
  3. C J McCann1,
  4. N A Cromie1,
  5. P Ferguson2,
  6. D C Catney3,
  7. F Kee4,
  8. A A J Adgey5
  1. 1Regional Medical Cardiology Centre, Royal Victoria Hospital, Belfast, UK
  2. 2Queen’s University, Belfast, UK
  3. 3Northern Ireland Cancer Registry, Belfast, UK
  4. 4Epidemiology and Public Health, Queen’s University, Belfast, UK
  5. 5Regional Medical Cardiology Centre, Royal Victoria Hospital, Belfast, UK
  1. Correspondence to:
    Professor A A Jennifer Adgey
    Regional Medical Cardiology Centre, Royal Victoria Hospital, Belfast BT12 6BA, UK; jennifer.adgey{at}royalhospitals.n-i.nhs.uk

Abstract

Objective: To determine the epidemiology of out of hospital sudden cardiac death (OHSCD) in Belfast from 1 August 2003 to 31 July 2004.

Design: Prospective examination of out of hospital cardiac arrests by using the Utstein style and necropsy reports. World Health Organization criteria were applied to determine the number of sudden cardiac deaths.

Results: Of 300 OHSCDs, 197 (66%) in men, mean age (SD) 68 (14) years, 234 (78%) occurred at home. The emergency medical services (EMS) attended 279 (93%). Rhythm on EMS arrival was ventricular fibrillation (VF) in 75 (27%). The call to response interval (CRI) was mean (SD) 8 (3) minutes. Among patients attended by the EMS, 9.7% were resuscitated and 7.2% survived to leave hospital alive. The CRI for survivors was mean (SD) 5 (2) minutes and for non-survivors, 8 (3) minutes (p < 0.001). Ninety one (30%) OHSCDs were witnessed; of these 91 patients 48 (53%) had VF on EMS arrival. The survival rate for witnessed VF arrests was 20 of 48 (41.7%): all 20 survivors had VF as the presenting rhythm and CRI ⩽ 7 minutes. The European age standardised incidence for OHSCD was 122/100 000 (95% confidence interval 111 to 133) for men and 41/100 000 (95% confidence interval 36 to 46) for women.

Conclusion: Despite a 37% reduction in heart attack mortality in Ireland over the past 20 years, the incidence of OHSCD in Belfast has not fallen. In this study, 78% of OHSCDs occurred at home.

  • AED, automated external defibrillator
  • CAD, coronary artery disease
  • CI, confidence interval
  • CPR, cardiopulmonary resuscitation
  • CRI, call to response interval
  • EMS, emergency medical services
  • OHCA, out of hospital cardiac arrest
  • OHSCD, out of hospital sudden cardiac death
  • PAD, public access defibrillation
  • SCD, sudden cardiac death
  • VF, ventricular fibrillation
  • sudden cardiac death
  • ventricular fibrillation

https://doi.org/10.1136/hrt.2004.059857

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    Footnotes

    • Published Online First 6 June 2005

    • None of the authors have any competing interests to declare

    • The study complied with the Declaration of Helsinki and received approval from the local research ethics committee, Royal Victoria Hospital, Belfast