Patients not receiving treatment they need.

• Position: Cardiac Arrest

A study of patients who died of sudden cardiac arrest, a usually fatal condition that causes the heart to stop beating, shows the majority who qualified to receive potentially lifesaving treatment did not get R.

Researchers led by Sumeet Chugh associate director of the Cedars-Sinai Heart Institute. Los Angeles. Calif., examined medical records of 2,093 patients who died of sudden cardiac arrest and found that 488 of them were medically evaluated to see if they met the criteria to receive an implantable cardiac defibrillator, which can shock a stopped heart into beating Of those 488 patients 92 were eligible to receive this treatment. However, further analysis showed that only 12 patients actually got a defibrillator.

"That tells us that, for some reason, even people who meet the guidelines are not getting this therapy." notes Chugh, chair of Cardiac Electrophysiology. "The data shows that most people aren't screened for sudden cardiac arrest but, even when they are eligible, they still are not getting proper treatment. The purpose of guidelines is to deploy treatments in the right people. It's not a question of more defibrillators or fewer, but a question of providing defibrillators to the patients who need them most.

Guidelines are standards of treatment established by a consensus of medical specialists. Additionally, the Centers for Medicare & Medicaid Services establish criteria for which patients qualify for certain interventions, such as defibrillator implantation.

Current y, the guidelines call For patients to receive defibrillators if their heart's election fraction--a measure of the heart's ability to pump blood is less than 35%. Of the 448 patients who did receive proper screening for...