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When a person's heart stops beating it may be necessary to deliver an electrical shock (called 'defibrillation') to the person's chest to restart their heart. Two electrodes are placed on the person's chest to allow the defibrillator to deliver the electrical shock. Historically, the electrical current applied to the chest has travelled in one direction between the electrodes. More recently, defibrillators have been designed to send the electrical pulse in one direction and then in the reverse direction. This is known as a 'biphasic' waveform.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

In some countries, intravenous (IV) magnesium is administered to heart attack patients in order to limit damage to the heart muscle, prevent serious arrhythmias and reduce the risk of death. Several small trials appeared to support the practice. But the authors of this review found that other trials went unpublished once they produced unfavorable results. A controversy erupted in 1995, when a large well‐designed trial with 58,050 participants did not demonstrate any beneficial effect to IV magnesium, contradicting earlier meta‐analyses of the smaller trials. This review includes 26 clinical trials that had randomly assigned heart attack patients to receive either IV magnesium or an inactive substance (placebo). Their results were mixed: IV magnesium reduced the incidence of serious arrhythmias, but this treatment also increased the incidence of profound hypotension, bradycardia and flushing. However, any apparent beneficial effects of magnesium may simply reflect various biases in these trials. Additionally, there was a lack of uniformity in these trials in terms of dosage and the timing of the IV magnesium regimen, which in some trials also included anti‐clotting drugs. The evidence produced by this review does not support continued use of IV magnesium. Other effective treatments (aspirin, beta‐blockers) should be used to treat heart attack.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Sudden cardiac death (SCD) is an important cause of death nowadays. People at high risk (mainly with any sort of heart disease) die unexpectedly from cardiac causes, primarily from arrhythmia (an irregular heartbeat). The treatment of choice is a device called an implantable cardiac defibrillator (ICD), but it is not widely available in low‐ or middle‐income countries. Amiodarone, an antiarrhythmic medication, might reduce the occurrence of these events and could be an alternative when an ICD is not available.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Sudden (unexpected) cardiac death is the leading mechanism of death worldwide. An unknown proportion of these deaths is caused by heart beat abnormalities that are passed on within families (inherited) that can lead to sudden cardiac death in otherwise healthy people. Four inherited diseases that affect the heart's electrical system, called congenital long QT syndrome, congenital short QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia, account for most of all inherited cases of sudden cardiac death. These people have abnormalities in the way in which their heart's balance electrolytes (naturally occurring substances in the blood and other body fluids that carry an electric charge) in a way that make them more likely to have higher sudden cardiac death rates than the general population. Two methods are used to prevent sudden cardiac death in these people: 1. implantable cardioverter defibrillators, which are small devices that provide electrical shocks to make the heart rhythm more regular, and 2. medical therapy (treatment with medicines that influence the heart's rhythm).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Out‐of‐hospital cardiac arrest (OHCA) is a major cause of death worldwide. Cardiac arrest occurs when the rhythm of the heart becomes disorganized and the heart becomes ineffective at pumping blood to the rest of the body. Prolonged periods of reduced oxygen to the brain can cause permanent damage. Cardiac arrest can be caused by, but is different from, a heart attack (myocardial infarction).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Dopamine improves low blood pressure (hypotension) in preterm babies more effectively than dobutamine in the short‐term, but evidence on safety and long‐term effectiveness is needed. Hypotension may cause brain injury and other serious problems for preterm babies (born before 37 weeks). Treatment aims to maintain blood flow to the brain and other organs, by using fluids or drugs to increase blood pressure. Inotrope drugs, including dopamine and dobutamine, are commonly used to increase blood pressure. However, the safest and most effective drug for treating hypotension in preterm babies has been unclear. The review found that dopamine was more effective than dobutamine for short‐term treatment, but the effects of these drugs on long‐term outcomes is unknown. More trials are needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

There is insufficient evidence to advocate the use of triiodothyronine supplementation for the prevention of postoperative morbidity and mortality in infants who undergo cardiopulmonary bypass.Thyroid hormones are integral in cellular metabolism and haemodynamic stability. A transient acquired hypothyroidism occurs after cardiopulmonary bypass and is thought to be associated with low cardiac output, left ventricular dysfunction, increased vascular resistance and impaired ventilatory drives. Thyroid hormone supplementation has been postulated as a possible therapeutic option to improve postoperative outcome measures. This review highlights the lack of evidence concerning the benefits and harms of triiodothyronine supplementation in infants who undergo cardiopulmonary bypass.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

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