HeartRunnerHot Line 12Acute Cardiac Care
Cardiac Arrest Survival Following Community First Responder Activation
Out-of-hospital cardiac arrest survival following community first responder activation
Presenting authorFredrik FolkeCross-Cutting Cardiology · Herlev and Gentofte University Hospital, DenmarkFredrik Folke is a Clinical Professor at the Department of Clinical Medicine, University of Copenhagen, and a Senior Consultant in the Department of Cardiology at Herlev and Gentofte Hospital. He also serves as Head of Research at the Copenhagen Emergency Medical Services in the Capital Region of Denmark. His clinical work includes echocardiography, medical rounds, and intensive care, while his research centers on out-of-hospital cardiac arrest, resuscitation, and public access defibrillation.
Overview
Results of community first responder activation trial pending; leaves open whether automated systems improve out-of-hospital cardiac arrest survival.
Key result
Community first responder activation for out-of-hospital cardiac arrest is the focus of a late-breaking trial with results currently pending.
Discussion
Expert reaction lands here the moment HeartRunner reports.
Expert takes
The HeartRunner trial evaluates a smartphone app that dispatches trained citizen volunteers to nearby out-of-hospital cardiac arrests (OHCAs) to provide CPR and retrieve AEDs before EMS arrival. Observational data from Denmark showed that when citizen responders arrived before EMS, bystander CPR increased (OR 1.76) and bystander defibrillation more than tripled (OR 3.73). A related Swedish randomized trial (SAMBA) using the same app was neutral for AED attachment, generating debate about whether the control group's high baseline performance masked a true effect. The randomized HeartRunner trial aiming to assess 30-day survival is ongoing.
Fredrik Folke
Senior Consultant, Herlev & Gentofte University Hospital
“I cannot think of other situations in which survival depends so strongly on time. Although ambulances respond rapidly in Denmark, the chance of survival may have dropped by 60–90% if nothing is done before the ambulance arrives.”
LA
Linn Andelius
Physician, Copenhagen Emergency Medical Services
“This was bystander interventions from both 'random' bystanders and citizen responders, but we found that citizen responders provided CPR in 69%, applied an AED in 50%, and defibrillated in 10% of all cases when they arrived before EMS. Importantly, these numbers were increasing with increasing EMS response times.”
Anezi Uzendu
Cardiologist, Saint Luke's Mid America Heart Institute
“The resuscitation community overall has been really excited about the prospect of improving bystander responses with technology and apps. I was definitely surprised that it ended up being negative, but I think the more you read into the study and start understanding what some of the flaws potentially could be and maybe some of the places where we need to ask more questions, we can try and figure out ways to improve app-based activation of rescuers.”
Ellinor Berglund
Researcher, Karolinska Institutet
“We do not interpret the lack of statistical differences between treatment groups to reflect the fact that the volunteer responder system does not have an effect. Instead, we conclude that the control group grew strong as a result of methodological issues. Therefore, our overall conclusion is that the volunteer responder system contributes to an increase in the overall use of AEDs and bystander CPR and may represent an important complement to the efforts of standard EMS and first responders.”
Puntos clave
- Out-of-hospital cardiac arrest survival serves as the primary clinical outcome evaluated following the automated activation of community first responders.
- Late-breaking trial findings compare emergency resuscitation endpoints with outcome data pending presentation at the ESC Congress 2026 meeting.
- Trial protocol assesses community first responder activation across emergency response networks to evaluate overall cardiac arrest survival benefits.
Resultado numérico
Tasa de eventos absoluta: 0% vs 0%