Key takeaways
- The HeartRunner trial assessed whether or not neighborhood first responder activation improved survival after an out-of-hospital cardiac arrest.
- 30-day survival was not considerably improved with neighborhood first responders vs. customary apply, however bystander CPR and defibrillation elevated and there have been no security issues.
- Additional research on the affect of first responders in areas with slower ambulance instances are warranted.
Munich, Germany – 31 August 2026: Neighborhood first responders didn’t enhance 30-day survival in sufferers with out-of-hospital cardiac arrest, in accordance with outcomes offered in a Scorching Line session at the moment at ESC Congress 2026.[1]
Out-of-hospital cardiac arrest is a time-critical emergency during which survival will depend on early recognition, early cardiopulmonary resuscitation (CPR) and early defibrillation. Many nations have developed smartphone-based techniques whereby volunteer first responders are mobilised to carry out CPR and defibrillation earlier than the arrival of the emergency medical providers.
“Though neighborhood first responders have gotten extra widespread, we solely have observational research to assist their use,” stated Principal Investigator of the HeartRunner trial, Professor Fredrik Folke from Copenhagen College Hospital, Denmark. “We performed a randomised research to firstly consider the affect of neighborhood responders on affected person outcomes and secondly, to reply the query about whether or not utilizing non-trained volunteers is secure.”
Within the HeartRunner trial, emergency requires suspected out-of-hospital cardiac arrest within the Capital Area of Denmark had been randomised (1:1) to neighborhood first responder activation plus customary response or customary response alone. In complete, 2,060 suspected cardiac arrests had been analysed in two strata primarily based on the estimated time from neighborhood first responder activation to arrival on the affected person’s aspect: lower than three minutes (0−358 metres away) and three to 9 minutes (360−1,080 metres away).
The researchers discovered that the first endpoint of 30-day survival was the identical whether or not first responders had been current or not. When estimated responder arrival time was lower than three minutes, 30-day survival was 15% in sufferers with neighborhood first responder activation vs. 17% with no neighborhood responder activation (p=0.42). When estimated responder arrival time was three to 9 minutes, 30-day survival was 13% in sufferers with neighborhood first responder activation vs. 14% with no neighborhood first responder (p=0.43).
Nonetheless, neighborhood first responder activation did considerably improve the speed of bystander CPR and doubled the speed of bystander defibrillation. For instance, when responder arrival time was three to 9 minutes, the bystander CPR elevated from 75% to 86% (p<0.0001) and bystander defibrillation from 6% to 14% (p<0.0001). Return of spontaneous circulation and survival with a beneficial neurological end result had been related between the 2 teams.
Explaining why he thought the first outcomes had been impartial, Professor Folke stated: “The trial was performed in an space the place ambulance response instances had been very brief, round seven minutes.” He continued, “Importantly, the trial confirmed that neighborhood first responder techniques could considerably enhance bystander CPR and defibrillation, however their impact on survival is very depending on the time obtainable for responders to intervene earlier than arrival of the ambulance. When this interval is brief, the incremental good thing about responder-initiated defibrillation could also be restricted. It will be attention-grabbing to evaluate their affect in areas with slower ambulance responses, together with extra rural areas.”
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