It’s been nine days since Damar Hamlin’s sudden cardiac arrest (SCA) during a Buffalo Bills-Cincinnati Bengals game shocked a national audience. A young man with a bright future who was enjoying the best performance of his career inexplicably collapsed on the field and had to be saved by attending trainers, physicians, and emergency crews. Lost in the subsequent speculations and arguments over the cause was that every year about 356,000 people experience an out-of-hospital cardiac arrest and nearly 90% of them die. Of those treated and transported to a hospital by well-equipped and trained EMS crews, survival to discharge remains around 10%[i].
Hamlin's sudden cardiac arrest was different in several key respects: it happened in front of an audience, he received immediate medical help, and he made it to the hospital alive. Others were not so fortunate including Pittsburg Steelers' great Franco Harris, Lisa Marie Presley, and Carry Fisher.
Hamlin was fortunate that his cardiac emergency took place in front of an audience and trained medical personnel. Other celebrities were not so fortunate including Pittsburgh Steelers’ great Franco Harris (72), Jacksonville Jaguars’ Uche Nwaneri (38), University of Central Florida’s Jake Hescock (25), and actors Carrie Fisher (60), Ray Liotta (67), and Brittany Murphy (32). I’ve consulted the literature and discussed SCA with clinicians who’ve expressed frustration with the tragically stubborn survival statistics.
I’ve also been asked if wearables and remote patient monitors could save the lives of victims experiencing unexpected cardiovascular events including SCAs. There are no simple technological solutions at this point beyond quick detection and summoning for help. In this context, wearables can help by detecting falling pulse rates and deterioration of related vitals; a few already trigger alarms to warn wearers and others in their vicinity. Still, a 10% survival rate for those who receive prompt attention, while better than zero, is not particularly comforting.
A better solution made possible by emerging monitors is for clinical researchers to analyze cardiovascular data and related contextual information from populations of patients who experience cardiac events. Advanced analytics and artificial intelligence are ideal tools that may yield practical patient risk profiles. For example, Apple is collecting vast quantities of data and health information from volunteers who use their iWatch. The company is partnering with various medical research institutions as part of its ongoing involvement with health and fitness research. On the clinical front, Biobeat is continuing to advance the value of advanced physiological monitors through research initiatives that included hundreds of Covid patients. Their sensors continuously capture over a dozen vitals including cuffless blood pressure to offer researchers unprecedented insights into patients' cardiovascular and respiratory systems.
It’s likely that these technologies and continuing research will bear fruit over the next five to ten years leading to early diagnoses, clinical interventions, and reductions in unexpected health emergencies including SCAs. Unfortunately, there are no simple solutions available at this time and it will take time to capture, analyze, and verify useful diagnostic profiles to guide effective clinical interventions. I will detail some of the promising research in my next post on this series.
Image references
Lamar Hamlin image courtesy of Wikipedia, Library of Congress, and Tom Williams. Per Wikipedia Commons: This work is from the Roll Call portion of CQ Roll Call collection at the Library of Congress. According to the library, there are no known copyright restrictions on the use of this work.
Lisa Marie Presley image courtesy of Wikipedia, Flickr, and David French, https://www.flickr.com/photos/thedonquixotic/14017741023/ via the Creative CommonsAttribution 2.0 Generic license.
Carry Fisher image courtesy of Wikipedia and Riccardo Ghilardi via the Creative CommonsAttribution-Share Alike 3.0 Unported license.
Franco Harris image courtesy of Wikipedia and Governor Tom Wolf via the Creative CommonsAttribution 2.0 Generic license.
References
[i] Mary M. Newman, Summary: Heart and Stroke Statistics – 2022, Sudden Cardiac Arrest Foundation, https://www.sca-aware.org/about-sudden-cardiac-arrest/latest-statistics.
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