Clinical Research
Heart Rhythm Disorders: Sudden Death
Cardiac Arrest at Exercise Facilities: Implications for Placement of Automated External Defibrillators

https://doi.org/10.1016/j.jacc.2013.06.048Get rights and content
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Objectives

This study sought to characterize the relative frequency, care, and survival of sudden cardiac arrest in traditional indoor exercise facilities, alternative indoor exercise sites, and other indoor sites.

Background

Little is known about the relative frequency of sudden cardiac arrest at traditional indoor exercise facilities versus other indoor locations where people engage in exercise or about the survival at these sites in comparison with other indoor locations.

Methods

We examined every public indoor sudden cardiac arrest in Seattle and King County from 1996 to 2008 and categorized each event as occurring at a traditional exercise center, an alternative exercise site, or a public indoor location not used for exercise. Arrests were further defined by the classification of the site, activity performed, demographics, characteristics of treatment, and survival. For some location types, annualized site incident rates of cardiac arrests were calculated.

Results

We analyzed 849 arrests, with 52 at traditional centers, 84 at alternative exercise sites, and 713 at sites not associated with exercise. The site incident rates of arrests at indoor tennis facilities, indoor ice arenas, and bowling alleys were higher than at traditional fitness centers. Survival to hospital discharge was greater at exercise sites (56% at traditional and 45% at alternative) than at other public indoor locations (34%; p = 0.001).

Conclusions

We observed a higher rate of cardiac arrests at some alternative exercise facilities than at traditional exercise sites. Survival was higher at exercise sites than at nonexercise indoor sites. These data have important implications for automated external defibrillator placement.

Key Words

automated external defibrillator
cardiopulmonary resuscitation
emergency cardiac care
sudden cardiac arrest

Abbreviations and Acronyms

AED
automated external defibrillator
CPR
cardiopulmonary resuscitation
EMS
emergency medical services
NETS
National Establishment Time-Series
PAD
public access defibrillation
ROSC
return of spontaneous circulation
SCA
sudden cardiac arrest
VF/VT
ventricular fibrillation/ventricular tachycardia

Cited by (0)

This work was supported in part by the Medic One Foundation, Seattle, Washington. Dr. Rea has received institutional grant support from Laerdal Foundation and Medtronic Foundation. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.