Sudden cardiac death – causes, prevention, resuscitation

25.09.2023 17:19

According to current figures from the German Resuscitation Register, more than 100,000 people in Germany suffer cardiac arrest every year, and resuscitation measures are initiated for at least 65,000 of them. The present heart report also shows a number of 65,000 people affected by sudden cardiac death.

But why is it that so many sudden cardiac arrests occur in supposedly healthy people? “A closer look at the cases shows that many of the
Those affected already have existing heart diseases,” explains Prof. Dr. Holger Thiele, President of the German Society for Cardiology - Heart and Circulation Research. V. (DGK). The most common causes of cardiovascular arrest are coronary heart disease (CHD) and heart failure with reduced pumping performance of the heart.

Heart failure is the most common single diagnosis in hospital admissions in Germany

In 2021, 597 out of 100,000 German citizens had to be hospitalized for CHD, men more than twice as often as women. Although this rate has been falling for years - probably because fewer and fewer people smoke, treatment has improved and more outpatient treatment is possible - it is still at a high level. Heart failure is now the most common single diagnosis in hospital admissions in Germany: 438,589 people were treated inpatients for heart failure in 2021. Although this number has also fallen in recent years, it is still well above the level in 2000. One reason for the increase is that more and more patients are surviving serious cardiovascular events such as heart attacks due to better therapies.

For example, in 2000, 67,282 people in Germany died of a heart attack. In 2021 there were only 45,181. If such an event is survived, damage to the heart muscle remains, which can cause secondary diseases such as heart failure. “To put it simply, you could say: more heart attacks survived lead to more heart failure, which in turn leads to more sudden cardiac deaths,” summarizes DGK President Thiele.

To protect patients at high risk of life-threatening cardiac arrhythmias from death due to sudden cardiac arrest, defibrillators can be implanted prophylactically, which deliver shocks in the event of ventricular fibrillation until the heart rhythm has normalized. In 2021, 37,721 of these devices were implanted in this country, 61.6 percent for primary prevention and 38.4 percent for secondary prevention of sudden cardiac death.

Every minute without chest compressions reduces the chance of survival by 10 percent

However, the chances of survival for most people affected by sudden cardiac death depend largely on how quickly and well the first resuscitation measures are initiated. For every minute that a person is not treated with chest compressions after a sudden cardiac arrest, the probability of survival decreases by 10 percent. In Germany, however, many people still shy away from starting chest compressions in an emergency.

Although the rate was increased from around 14 percent in 2010 to around 46 percent in 2021, Germany still does not do well in a European comparison. Other countries such as Norway or the Czech Republic achieve resuscitation rates of over 80 percent. “In order to achieve this in Germany too, we can follow the well-functioning measures in other countries,” says Thiele. “This includes resuscitation lessons in schools once a year from the 7th grade onwards, mandatory telephone resuscitation instructions for rescue centers and the nationwide introduction of app-based first aid systems.”