Study shows defibrillation pad placement may improve cardiac arrest outcomes

Editor's Note

A recent observational study published in JAMA Network suggests the placement of defibrillation pads during cardiac arrest treatment could significantly impact survival rates, Cath Lab Digest September 23 reports. The study analyzed 255 cases of cardiac arrest where the two pads were placed either at the front and side or front and back of the patient and found that placing defibrillator pads in the front and back increased the likelihood of returning spontaneous circulation by 2.64 times, compared to the traditional front and side placement.

Researchers used data from the Portland Cardiac Arrest Epidemiologic Registry, which recorded the placement position of defibrillation pads from July 1, 2019, through June 30, 2023, noted the outlet. This finding challenges the current assumption that either pad placement is equally effective. The study emphasized that defibrillation pads placed in front and back may more effectively “sandwich” the heart, delivering a stronger electrical current through the organ. However, practical challenges, such as patient weight or body positioning, can complicate this approach. Senior author Mohamud Daya, MD, stressed the importance of delivering the shock as quickly as possible, regardless of pad placement.

Lead author Joshua Lupton, MD, MPH, a cardiac arrest survivor himself, said he was surprised by the results and believes this may prompt additional research to further explore the benefits of pad placement during cardiac arrest. The study, while not a clinical trial, points to the potential for improving the dire survival rate, as less than one in 10 people survive cardiac arrest outside of a hospital.