The European Sudden Cardiac Arrest network towards Prevention, Education, New Effective Treatment
Sudden cardiac arrest (SCA) is a vast public health problem, causing ~50% of cardiac death and ~20% of all natural deaths in Europe. This problem is expected to rise further as the population ages. SCA is the sudden cessation of the heart’s ability to pump blood through the body. SCA is due to cardiac causes that result in cardiac arrhythmia (ventricular fibrillation, VF). SCA is lethal within minutes if left untreated, yet mostly occurs in the community, where treatment is usually not immediately available. Accordingly, survival rates are presently only 5-20%. While improvements in primary and secondary prevention have resulted in substantial declines in overall mortality from heart disease in general and coronary heart disease in particular over the past 30 years, SCA rates have declined to a lesser extent and may be on the rise in some segments of the population.
Also, there are great disparities in SCA incidence and survival rates after SCA across Europe and the world. Clearly, SCA prevention is a major opportunity to further reduce mortality from heart disease. This requires early recognition of individuals at risk and an understanding of the causative factors on an individual’s level. This knowledge is still lacking, and SCA now usually occurs unexpectedly, often in individuals who are unaware of their increased risk. Much improvement must be gained here. Also, new treatment strategies for SCA have shown to increase survival rates. Further improvements in this area are also crucial.
The ESCAPE-NET consortium members have invested heavily in the last decades to create such infrastructures and have collected large European SCA cohorts with the required information, including DNA samples collected during resuscitation. In isolation, these cohorts are already world-leading with respect to size and data quality. ESCAPE-NET will elevate these cohorts synergistically by adding new data on novel potential risk factors, thus far underappreciated in SCA research, in particular socio-economic and psychosocial stressors. This new data will be obtained by ESCAPE-NET partners who are specialized in linkage of study cohorts to regional and national registries which contain these novel factors. A comprehensive integration strategy of these joint exceptionally large and complete datasets constitutes a quantum leap in SCA research, and offers a unique opportunity, out of reach so far, to design strategies for truly personalized medicine.
To further promote this ambition, ESCAPE-NET will also take advantage of smart phone applications and ICT solutions, including mobilization of lay rescuers with the aid of app-based or text messaging-based systems, and waveform analysis to optimize first-response treatment according to the 3-phase model of resuscitation.