New Delhi: The Lancet Commission looking into ways to reduce the global burden of sudden cardiac deaths (SCD) has called for multidisciplinary action such as ensuring public access to defibrillators and affordable genetic testing for risk assessment.
According to the United States National Library of Medicine, sudden cardiac death is ‘death due to a cardiovascular cause that occurs within one hour of the onset of symptoms’. Sudden cardiac arrest ‘occurs when the heart stops beating or is not beating sufficiently’. A defibrillator is a device that applies an electric shock to the heart to restore a normal heartbeat.
In its report published in The Lancet medical journal Sunday, the commission — a panel of international experts — said that SCD may account for 15-20 percent of overall mortality worldwide, with millions of deaths each year.
According to the report, public access defibrillators should be registered, accessible and linked directly to emergency services, and the possibility of defibrillator transportation by taxi or drones should be further explored.
Further, genetic testing for SCD risk should be expanded and made more affordable at a global level.
“The commission places substantial emphasis on the need to develop a multidisciplinary strategy that encompasses all aspects of SCD prevention and treatment,” the report stated, underlining that survival rate from sudden cardiac arrest remains lower than 10 percent in most parts of the world.
This may have implications for a country like India, where frequent cases of sudden cardiac arrests are being reported, purportedly due to the Covid-19 pandemic and effects of air pollution, and there is anecdotal evidence that more younger people may be falling prey.
A 2012 study conducted on SCD in southern India estimated that it contributed to nearly 10.3 percent of overall mortality in the population and on an average, patients with heart problems were 5-8 years younger compared to populations reported in the West, primarily due to a high prevalence of major risk factors for coronary artery diseases.
A large study published by US researchers in the journal Nature last year had shown that, after the first 30 days of infection, individuals who had Covid-19 were at increased risk of cardiovascular diseases spanning several categories, including cerebrovascular disorders, an umbrella term for conditions that impact the blood vessels in the brain.
Cardiovascular diseases are a known risk factor for SCD.
Also Read: ‘Men get priority’: Data shows Indian women get less access to heart, transplant surgeries
Risk factors
According to Dr Ajay Kaul, chairman, cardiac sciences, at Fortis Hospital in Noida, SCD often occurs due to underlying heart conditions, such as arrhythmias (abnormal heart rhythms), coronary artery disease, and structural heart abnormalities.
These conditions can disrupt the heart’s electrical signals, leading to a sudden loss of effective pumping function, he said.
Dr Vivek Chaturvedi, head of the cardiology department at Amrita Hospital in Faridabad, pointed out that sudden cardiac death is a leading cause of death worldwide, especially in low- and middle-income countries.
“In India, where premature coronary artery disease is already a huge concern, SCD has enormous societal implications,” Dr Chaturvedi said.
Need to identify problems early
To prevent SCD in India, a multidisciplinary approach is essential, said Dr Kaul, adding that educating the public about the importance of recognising heart attack symptoms, seeking timely medical attention, and adopting a heart-healthy lifestyle can make a significant difference.
“Encouraging regular health check-ups and screenings for individuals at risk of heart diseases, including those with a family history of cardiac issues, can help identify problems early,” he said, adding: “Timely medical interventions like medications, surgeries, or implanted devices such as pacemakers, and defibrillators can manage underlying heart conditions and reduce the risk of SCD.”
According to Dr Rasesh Pothiwala, director in the department of cardiology at Sterling Hospitals in Ahmedabad, family history plays a pivotal role, with genetic testing, which is currently expensive but capable of detecting heart disease, assuming a significant role.
“Expanding genetic testing for individuals at risk of inherited heart conditions can help identify potential problems before they lead to SCD,” said Dr Kaul, adding that ongoing research can provide insights into the prevalence and causes of SCD specific to the Indian population.
Implementing policies and regulations to ensure that public places, workplaces and educational institutions have access to defibrillators and trained personnel can be crucial, the doctors said.
(Edited by Nida Fatima Siddiqui)
Also Read: More patients going to hospitals, making insurance claims for heart issues since lockdowns