in focus: combating cardiac arrest

Pittsburgh has been a forerunner in resuscitation medicine since the 1960s when Dr. Peter Safar, an anesthesiologist at the University of Pittsburgh’s School of Medicine and a Mt. Lebanon resident, established many of the practices used for modern-day CPR. Pitt’s School of Medicine continues at the forefront of cardiac research. Recently, the National Heart, Lung and Blood Institute, a division of the National Institutes of Health, awarded the school a grant of $1.8 million to analyze more than 16,000 electrocardiograms (ECG) of sudden cardiac arrest victims.

Lavina Avenue resident James Menegazzi, professor of resuscitation research at Pitt’s School of Medicine, will lead the project, which he says will create one of the largest ECG databases of its kind. “Our findings will provide new information to help revise CPR guidelines and improve patients’ lives,” he says.

Lab discussion with Dr. Menegazzi
Lab discussion with Dr. Menegazzi

According to the American Heart Association, immediate CPR can double or triple a sudden cardiac arrest victim’s chance of survival. However, fewer than 7 percent of the nearly 351,000 Americans who annually suffer out-of-hospital cardiac arrest live long enough to leave the hospital. Many cardiac arrests occur as a result of ventricular fibrillation (VF), when irregular contraction of cardiac muscle fibers prevents the heart from pumping blood. Although defibrillation can treat VF, all VF episodes are not the same.

Throughout the four-year study, Pitt will collaborate with the University of Washington and other Resuscitations Outcomes Consortium organizations. Menegazzi says they will use the research to analyze VF patterns and evaluate resuscitation procedures. They may also be able to pinpoint which rate of chest compressions is most beneficial for CPR.

Cardiac research has extended lives well beyond what Safar, who died in 2003, might have imagined when he founded Pitt’s International Resuscitation Research Center, later renamed the Safar Center for Resuscitation Research in his honor. “Over the last few decades in Pittsburgh, we’ve seen the survival rate for patients with sudden cardiac arrest double,” says Menegazzi.

The project’s results could inspire future academic studies, as well as tell defibrillator manufacturers the best settings for delivering an electrical shock. “These ECG reports have been sitting somewhat idle,” he says, “but, with the grant, we can do detailed analyses to allow us to see what is working best with CPR and medicine.”