Response to Post About ARVD and The Contraindications of CPR?

I received a feedback post that I wanted to respond to by video:

The post read as follows:

Roy,

My wife has a heart condition called ARVD. This involves the RIGHT VENTRICAL and the things you are asserting(about CPR) will injure or kill the person.  Please see the website at Johns Hopkins on ARVD. This is a congenital heart disease that WILL NOT RESPOND TO STANDARD RESCUE PROTOCOLS. Because it involves the right ventricle the symptoms and treatments are all different. Lynn wears a Medic Alert bracelet and part of the information is to NOT perform standard CPR protocols, but to contact her doctors for information on how to proceed. She has a pacemaker and ICD, and cannot be given lidocaine or any of the standard cardiac resusitation drugs that ACLS requires. We will add that oxygen, lying on the left side and transporting to a facility familiar with heart electrophysiology, and ARVD treatment. This disease is found in athletes (runners, football and basketball players,
tennis and extreme sports) who seem on the outside to be fit, but have a heart that is not functioning as it should. This disease runs in families and it traceable through genetic testing at Johns Hopkins.

-A

 

It must be difficult having a loved one struggle with a cardiovascular disease as mysterious as arrhythmogenic right ventricular dysplasia(ARVD), but I want to reiterate that CPR performed by bystanders will still give more benefit than doing nothing at all.

The fact that the right ventrical is dysplastic should not have anything to do with CPR performed as an emergency intervention in order to try and circulate any increased amount of oxygenated blood to the brain and vital organs.   As with everyone who goes into sudden cardiac arrest, there is no study showing that any amount of CPR would make a cardiac arrest victims biological condition worse.  If left alone, and no automatic circulation and oxygenation is present,  the body would continue to go without gas exchange circulation.  This is why most emergency protocols, and 911 systems will encourage CPR regardless of the underlying pathology related to the cause of death.  Out in the field, the goal is to keep the victim biologically alive enough to make it to the hospital or advanced care where when applicable, reversible conditions can be made right.  I did contact John Hopkins and after a short discussion with an ER nurse, it was confirmed that ARVD has different protocols for cardiac arrest.  Most victims of ARVD do not know they have it and therefore would present as a spontaneous sudden cardiac arrest event.  If this occurs, most EMS 911 dispatch systems are going to encourage CPR. I hope this helps and I’ll let you know what I find out from the American Heart Association when they respond to my question for clarity regarding this special case. I hope this helps.

Best Wishes,

Roy, RoyOnRescue.com

Roy Shaw

Roy is the lead trainer and co-founder of ProTrainings. He is also an EMT paramedic whose opinions about rescue come from many years of experience on the ambulance.

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One comment on “Response to Post About ARVD and The Contraindications of CPR?

  1. Mr. A, i am glad that you are educated about your wife’s condition. If I was the 1st responder, i couldnt sit n do nothing. I would pray while I do CPR on your wife. The average Joe will not know about her condition despite the bracelet. I understand the protocol us different but I am interested to know what AHA recommends.

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