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Boosting heart attack survival

When cardiac arrest happens outside of a hospital, the survival rate is dismally low … less than 10%. These sudden heart attacks claim the lives of about 340,000 U.S. adults every year.

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The current standard of care for cardiac arrest usually includes cardiopulmonary resuscitation (CPR), defibrillation, intubation, and intravenous drugs. However, a recent trial called Advanced Reperfusion Strategies for Refractory Cardiac Arrest (ARREST), using a life support machine to temporarily take over the functions of the heart and lungs, significantly improved the survival of its first participants who suffered from out-of-hospital cardiac arrest. In fact, it was so much more effective that the trial was stopped early, after enrolling just 30 of the expected 165 patients.

The machine used in the ARREST trial is called extracorporeal membrane oxygenation (ECMO). That acronym may sound familiar because ECMO, which channels blood out of the body and into a circuit of equipment that adds oxygen to it before pumping it back in, is also helping to save the lives of many people who are critically ill with COVID-19. 

The early phase of the trial found that using ECMO as part of a broader program of care for cardiac arrest resulted in the survival of six of 14 patients, compared with just one of 15 patients receiving standard treatment. Their average age was 61, and 25 of the 30 were men. At three and six months after hospital discharge, all six people who received ECMO were still alive, while the remaining patient who received standard treatment had died. 

“The favorable survival rate in this study is very encouraging and is helping to pioneer new pathways in advanced cardiac care and transform outcomes for patients with cardiac arrest,” said Dr. Tom Aufderheide, ARREST’s co-investigator and senior study author. “This is the first trial to show a significant difference in outcomes after hospital admission among patients treated for out-of-hospital cardiac arrest with a team-based ECMO strategy.” 

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