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A recent article in the Journal of the American Medical Association reported that cardiac arrest and its survival varied greatly (five fold) depending on where the cardiac arrest occurred. Survival was low no matter where a person lived among the 10 North American cities or states in the study. Rates ranged from 1.1 percent in Alabama to 8.1 percent in Seattle. Most cardiac arrests are due to a sudden heart attack, and a heart attack can manifest itself as a cardiac arrest in about one-third of cases. Therefore, anyone suspecting a heart attack should take quick action by calling 911. Taking quick action in the case of cardiac arrest increases survival because help is on the way. Signs of a heart attack are intense and may include one or more of the following: chest pain, arm pain, jaw pain, sweating, palpations, nausea and light headedness. Differences in rescue of cardiac arrest victims vary between regions due to many factors. Availability of external defibrillators is a primary factor. However, simply having defibrillators is not enough. Responders need to know how to administer CPR and properly work the defibrillator. Cardiac arrest associated with rhythm called ventricular fibrillation that can be converted to normal rhythm with a defibrillator is tied to a higher survival rate. The survival with this rhythm and prompt defibrillation with an external defibrillator ranges from 7.7 to 39.9 percent, depending on geographic region. Why is geographic variation significant? Availability of defibrillators, knowledge and skill of responders, and response time are key factors. Responders also must be motivated to rescue cardiac arrest victims. The use of CPR during emergency assistance varies from 40.3 to 86.7 percent. In other words, in some communities, the majority of bystanders choose to do nothing. In other communities, a large majority choose to respond. Perhaps emergency response is a product of public education. On the other hand, the choice to not respond could be influenced by fear. An argument can be made for intense community education regarding methods of cardiopulmonary resuscitation (CPR). Likewise, purchase and distribution of defibrillators, along with instructions on proper usage could help improve survival rates. Most hospitals offer CPR education as a public service. Anyone interested in healthy aging should insist on widespread community efforts to train people who are likely to encounter the next cardiac arrest. MUSC Online Resources Related to Cardiac Arrest:
MUSC Heart and Vascular Center
MUSC Podcast Library: Cardiac Arrest
MUSC Heart Aware: Heart Risk Assessment 
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