Video: Seattle the best place to have a heart attack

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It happens suddenly and often without warning.

"Cardiac arrest is the loss of mechanical activity of the heart," said Dr. Graham Nichol of the University of Washington

Dr. Nichol and his colleagues analyzed data from more than 20,000 cases of out-of-hospital cardiac arrest across these ten regional areas in North America. What they found is that just more than half of these patients received any kind of CPR and less than one in 20 survived. Survival rates varied greatly depending on where a patient lived.

"Someone in one community is two hundred percent more likely to have cardiac arrest and five hundred percent more likely to die when they have cardiac arrest," said Dr. Nichol.

Survival from cardiac arrest ranged from 3 percent to 16.3 percent, with Seattle at the top of the list.

For ventricular fibrillation where the heart muscle goes into an erratic rhythm, survival ranged from 7.7 percent to 39.9 percent, again Seattle in the lead.

Such large discrepancies appear to be associated not only with a patient's personal risk for cardiac arrest but also with differences in the local approach to emergency response.

"Some communities may need to train more of the public to recognize and respond to medical emergencies other communities may need to focus on improving their local organized emergency response,' said Dr. Nichol.

Researchers found that only about a quarter of patients in the study received CPR from a bystander. They say part of the reason is because cardiac arrest often occurs in the home with nobody around but also because not enough people are trained in CPR.

Researchers say if survival rates can be improved, thousands of premature deaths would be prevented each year.