The Egyptian Cardiac Arrest Project “ECAP”
Background :
In out of hospital cardiac arrest, only one third of those patients receive CPR from a bystander and only 2% receive Automatic external defibrillation, hence in success rate of resuscitation varies between 7.9-9.2%.
ECAP project aims to:
- Surveying the magnitude of the problem in Egypt
- Increasing the awareness of the community with this devastating condition
- Training the lay people, as well as healthcare providers for resuscitation to help save lives in witnessed conditions
- Investigating and treatment of those at risk for occurrence
The program is carried out by:
- The Egyptian College of Critical Care Physicians (ECCCP)
- The program is sponsored and funded by National Bank of Egypt and Misr Al-Kheir Foundation
Program Phases
The program consists of 3 major elements; Screening, Training, and primary/ secondary prevention arms.
This will be carried out in 3 phases. (Initially sequentially then simultaneously)
Screening Phase
- Surveying the incidence of in and out of hospital sudden cardiac death.
- Screening for risk factors for sudden cardiac arrest among the general population (patients and their families)
- Increasing public awareness for the importance of risk modification and treatment whenever possible
According to the target population of the community, first phase will be simultaneously conducted within Hospitals, as well as in public places:
1- Healthcare providers Including:
A. Recruiting high risk patients for investigation and primary/ secondary prevention. Training will be carried out either on site within the vicinity of the organization itself as hospitals and medical centers, or off-site, in one of the affiliated centers in cooperation with the ECCCP.
Training Phase
Training non-healthcare providers (lay people) for basics of resuscitation using the American Heart Association programs, as well as the Egyptian Arabic program.
Diagnostic Phase
After Screening for previous personal or family history or the presence of risk factors for SCD, patients will be further evaluated in ECCCP verified centers and clinics. This will include the following:
I. For Coronary Heart Disease:
- A-Holter monitoring.
- B-Stress testing (with / without Radioisotopic scanning).
- C-Coronary Angiography / CT angiography.
II. For arrhythmias:
- A. Holter monitoring / long term monitoring
- B. Signal Average ECG
- C. T Wave Alternans
- D. Tilt Table Testing
- E. Genetic assessment for congenital arrhythmias
- F. Electrophysiologic Studies
This is the phase of treatment of direct risk factors and primary/secondary prevention of SCD. This includes the following:- Coronary Artery Disease; Revascularization (PCI-CABG) + medical treatment.
- Arrhythmias: Ablation, medical treatment
- Device Therapy including ICD, CRT, CRTD (according to the underlying disease and ejection fraction)
