Activation of automated external defibrillators in the Buenos Aires subway: experience of a public cardioprotection program

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Abstract

Background: Out-of-hospital sudden cardiac death is one of the leading causes of cardiovascular mortality worldwide. Early defibrillation is the most important determinant of survival in patients with shockable rhythms , particularly ventricular fibrillation. For this reason, numerous international guidelines recommend the implementation of public defibrillation programs in high-traffic areas.

Objective: The aim of this study was to report the response system activations and use of automated external defibrillators (AEDs) in the Buenos Aires City subway system following the implementation of a cardioprotection program. Methods: A descriptive observational study was conducted based on the program’s operational registries between 2018 and 2024. All instances in which system personnel responded to retrieve an AED in response to events potentially consistent with cardiac arrest were analyzed. 

Results: During the study period, 27 system activations were recorded. In 15 cases, the AED was applied to the patient analyzing the heart rhythm. Among the cases analyzed, 14 shockable rhythms and 1 non-shockable rhythm were identified. In 12 cases, the process was interrupted due to the patient regaining consciousness or the identification of events not consistent with cardiac arrest. Survival was confirmed in 7 patients.

Conclusions: These results suggest that the program enabled an adequate response to this extreme situation.