Information for professionals - ARREST

ARREST studies out-of-hospital cardiac arrest in the province of North-Holland and the Twente region in the Netherlands. ARREST stands for AmsteRdam REsuscitation STudies, and records characteristics of out-of-hospital resuscitation attempts and studies risk factors of sudden cardiac arrest. This website provides background information of ARREST.

Sudden out-of-hospital cardiac arrest

In the Netherlands, 30.000 people have a sudden cardiac arrest each year, and approximately 7.500 out-of-hospital resuscitation attempts take place. Around 15 people die every day as a result of a cardiac arrest. Therefore, investigating which factors increase the risk of a cardiac arrest and studying how resuscitation attempts outside hospital are performed is very important. (source: ‘Reanimatie in Nederland, 2016 (Hartstichting)’ [Dutch]).

Current research

Out-of-hospital resuscitation

The ARREST study is an ongoing prospective registry of all resuscitation attempts in the province of North Holland: an area of 2.4 million inhabitants. Since 2010, the ARREST database also includes resuscitation attempts in the Twente region. The purpose of the data collection is to determine which factors are most important for patient survival, and to see where there are possibilities for improvement in the chain of survival. To this end ARREST cooperates with all ambulance services, dispatch centres and hospitals in the study regions, and collects data from police, fire fighters and lay persons to analyse the first response to a sudden cardiac arrest, including the effective use of automated external defibrillators (AEDs). This publication of the Dutch Heart Foundation gives more details.

Risk factors

Why does one person have a cardiac arrest whereas another person does not? ARREST studies which combination of risk factors can lead to the occurrence of a sudden cardiac arrest. We study the role of diseases and hereditary factors, but also the use of medication and environmental factors.

ESCAPE-NET

Since January 2017 we officially work together with other sudden cardiac arrest research groups in Europe, in the ESCAPE-NET project: European Sudden Cardiac Arrest Network - Towards Prevention, Education and New Effective Treatment, supported by the EU. In this project, international experts with different backgrounds work together share their data, knowledge and expertise. See the website of ESCAPE-NET for more information.

Recognizing Sudden Cardiac Arrest Vulnerability in Diabetes (RESCUED)
Aim project: To identify individuals at high risk for Sudden cardiac arrest (SCA) in people with type 2 diabetes focusing on general practitioner (GP) files and molecular markers (DNA, metabolomics).

SCA is a vast general health problem, causing 50% of cardiovascular mortality and 20% of total mortality in The Netherlands. Only 20% survive SCA, and survivors may suffer significant residual disability. Yet, SCA mostly strikes individuals whose SCA risk was unknown to themselves and their general practitioners (GPs) and accordingly, a substantial part of SCA victims (40-50%) was never seen by cardiologists prior to SCA. Additionally, people with type 2 diabetes have a 3 fold higher risk of SCA. Clearly, recognition of individuals at risk must be improved. This will enable patients to seek timely medical care, and GPs to treat and/or refer these patients to cardiologists, and it will allow the design of preventive strategies. Furthermore, the (molecular) mechanisms that underlie SCA risk in people with type 2 diabetes will be investigated through the use of so far untapped methods in SCA research in people with type 2 diabetes (genetics, metabolomics).

The RESCUED project contains several innovative aspects:
1. Information in GP files will be unlocked using data mining. Through data mining of GP files, we will investigate whether symptoms and clinical signs, at present deemed nonspecific and irrelevant, may distinguish individuals at risk of impending SCA. This state-of-the-art method may also be applicable to SCA research in people with other diseases i.e., people without diabetes.
2. Genetic markers for SCA in the community among individuals with type 2 diabetes will be investigated, as opposed to rare patient/families with inherited arrhythmia syndromes typically seen at Cardiogenetics departments. This analysis includes both common variants (GWAS) and rare variants (whole exome sequencing).
3. Metabolomic profiles associated with SCA in the type 2 diabetes population will yield tools for early detection of those at increased SCA risk. Furthermore, it might provide novel clues about its etiology. Metabolomic profiling has already been used successfully to identify prospective markers for type 2 diabetes and cardiovascular disease.

Role of research group in this project: Petra Elders and Amber van der Heijden are part of the coordinating team of RESCUED. Further, Petra Elders Amber van der Heijden and Joline Beulens are involved in the supervision of the PhD students in RESCUED. The RESCUED project is closely connected to the ARREST-study and ESCAPE-net project.

Team

J.L van Schuppen, MD Anesthesiologist, Project leader Resuscitation Research
H.L. Tan, MD PhD Cardiologist, Project leader Risk of sudden cardiac arrest
R.W. Koster, MD, PhD Cardiologist, founder, advisor
M.M. Ekkel, MSc Researchcoördinator
R. Stieglis, MSc Datacoordinator, PhD student
V.G.M. van Eeden, MSc Datamanager
R. Kalk, MSc Datamanager
E.C. Linssen, MSc Datamanager
M. Bak, PhD Post-doc
R.L.A. Smits, MSc PhD student
B.J. Verkaik, MSc, MD PhD student, MD
L.C. Doeleman, MSc, MD PhD student, MD
B. Verbruggen, MSc PhD student

Partners

ARREST collaborates with:

  • Ambulance services and emergency dispatch centers
  • Fire Department
  • Police Department
  • Hospitals
  • General practitioners
  • Pharmacies
  • Dutch Heart Foundation
  • HartslagNu
  • Hartveilig Wonen
  • City AED
  • Dutch Resuscitation Council (NRR)
  • European Resuscitation Council (ERC)
  • European Heart Rhythm Association, European Society of Cardiology

Data from ARREST is also part of three European collaborations:

  • ESCAPE-NET
  • EuReCa
  • COSTA

ARREST is financed by several organisations:

  • EU H2020 grant agreement nr 733381
  • CVON ‘CardioVasculair Onderzoek Nederland’: Dutch Heart Foundation, NFU, NWO, and KNAW (no. 2012-10 PREDICT project)
  • Dutch Heart Foundation
  • NWO, grant ZonMW Vici 918.86.616
  • Medicines Evaluation Board (MEB/CBG)
  • Laerdal Foundation
  • Industry: Physio-control, Zoll medical services, Cardiac Science, Defibtech, Philips (none of these companies has any influence on research questions, methods and results of ARREST).

Publications

Our publications can be found on PubMed.

Information about the ARREST study

Naar de Nederlandstalige site

Visiting address

ARREST research Department of Cardiology Amsterdam UMC (AMC) HvA, A1-28 Tafelbergweg 51 1105BD Amsterdam

You can reach us by phone: Mo-Fr 08:30-16:00 hours Tel.: +31 20 566 5969
Fax: +31 20 566 9131

E-mail arrest@amsterdamumc.nl