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A patient in cardiac arrest may present in a heart rhythm that is either “shockable” or “not shockable.” (Click here to learn more about cardiac arrest) Patients presenting in “shockable” rhythms represent those who are most likely to survive, and the most common rhythm that these patients present with is called ventricular fibrillation (VF).
VF is an abnormal and rapidly lethal rhythm that represents a disorganized electrical and mechanical state. In essence, the heart can be thought of as “shivering.” The problem with this rhythm is that it produces rapid and constant contraction of the heart muscle while preventing blood flow to that muscle. As a result, the heart quickly uses up its own oxygen and nutrient supply, resulting in death if not corrected.
The treatment for patients in VF is defibrillation. A defibrillator attempts to send an electrical “shock” through the heart, resetting all electrical activity so that the heart’s own pacemaker can take over and restore a normal heart rhythm. With each minute that passes after the VF begins, the likelihood that this will happen and that the patient will survive decreases.
Automated external defibrillators (AEDs) are machines whose internal computers are designed to analyze the patient’s heart rhythm to determine if a “shock” is needed. In this study, we will utilize the AED currently used by the FDNY to investigate the ability of a new computer program to assign each individual patient to the treatment that is most likely to benefit them based on the characteristics of the heart rhythm.