“Sudden cardiac death” and “cardiac arrest” are interchangeable terms describing an unexpected death from a cardiac cause within 1 hour of onset of symptoms, with a staggering worldwide annual incidence of 2.2 million; in the United States, the reported annual incidence of emergency medical services (EMS)–treated cardiac arrest is 107 000 to 240 000 (http://www.census.gov). The “chain of survival” concept originally proposed by the Advanced Cardiac Life Support (ACLS) Subcommittee and the Emergency Cardiac Care Committee of the American Heart Association (AHA) in 1991 promoted 4 key elements or links, including rapid access, rapid cardiopulmonary resuscitation, rapid defibrillation, and rapid ACLS measures.1 Cardiocerebral resuscitation has been proposed as a new approach—albeit complementary to the established paradigm of cardiopulmonary resuscitation—and includes continuous chest compressions without mouth-to-mouth ventilations for witnessed arrest. These new EMS/ACLS algorithms and aggressive postresuscitation care are now incorporating therapeutic hypothermia and early catheterization/percutaneous coronary intervention.2 In addition, newer paradigms are on the horizon regarding aggressive and early treatment of cardiogenic shock using one of the many available left ventricular assist devices in conjunction with interventional approaches to establish expeditious antegrade flow in the infarct-related artery.
Seyal MS. The Textbook of Emergency Cardiovascular Care and CPR. JAMA. 2009;301(20):2162–2163. doi:10.1001/jama.2009.731