Daniela Aschieri, S Bricoli, Luca Rossi, Stefano Ferraro, Maria Giulia Bolognesi, Stefano Nani, Valentina Pelizzoni, Gianluca Pagnoni, Alessandro Capucci
Background Out‐of‐hospital cardiac arrest remains a significant public health challenge, characterized by poor overall survival. Early defibrillation is crucial to manage fatal arrhythmias. The use of automated external defibrillators is a promising tool in minimizing time to defibrillation and enhancing survival. Methods PV (Progetto Vita) in Piacenza pioneered the first community‐based automated external defibrillator project in Europe. We present survival data spanning 23 years for all cases of out‐of‐hospital cardiac arrest managed under both PV and standard emergency medical services interventions. Results A total of 6996 out‐of‐hospital cardiac arrests were recorded. Among these, 156 cases were managed by PV volunteers (PV group). The PV group managed a significantly higher proportion of shockable rhythms than the emergency medical services group (69.9% versus 10.9%). Mean time to arrival was shorter (5.7 versus 10.2 minutes), and survival rates better with favorable neurological outcomes (46.2% versus 2.9%, overall). Survival rates declined with time. However, a higher proportion of patients in the PV ‐group demonstrated favorable neurological outcomes, even up to 9 minutes from the call, compared with the EMS group. Over the study period, the increasing number of automated external defibrillators in fixed public places coincided with a substantial rise in ventricular fibrillation survival in the PV group patients (22% for 2003–2012 to 73% for 2013–2022, P <0.001). Both time from call to arrival and PV‐group intervention emerged as independent predictors of survival (odds ratio 1.08 and 0.28, respectively). Conclusions Our simplified automated external defibrillator‐focused training for community has shown higher survival rates and emerges as a highly successful strategy in a small city.