MONDAY, Jan. 5 (HealthDay News) -- Deanna Babcock's heart stopped beating on July 20, 2007. Just like that.

"I was swimming in a pool at North Carolina State University, doing normal laps," recalled Babcock, who was 23 years old and in excellent health, or so she thought. "My strokes started getting sloppy, and I coasted to a stop face down."

Jim Stoltz's heart stopped on July 1, 2006. "I was sitting at my desk," said Stoltz, 66, who is an accountant who lives in Flanders, N.J. "I don't recall much. I simply went under my desk. I woke up five days later in the hospital."

Both Babcock and Stoltz were victims of sudden cardiac arrest, in which the electrical system that controls the heart's beating simply stops working the way it should. It is a condition that causes more deaths in the United States than breast cancer and lung cancer combined. An estimated 95 percent of those who experience it die before reaching a hospital.

These story endings were better, mostly because people who saw what was happening knew what to do. "They told me that co-workers standing by and two others immediately started CPR [cardiopulmonary resuscitation]," Stoltz said. "It's a combination of chest compression and breathing. They did it for about 10 minutes, until the emergency medical service arrived."

"They used a defibrillator on me," Babcock said, referring to a device available in some public places that delivers an electrical jolt to start the heart beating again. "A lifeguard did it."

Stoltz is back at work now, feeling "pretty good, almost back to the level of exercise I was doing prior to that."

Babcock's story is less happy "When I had some trouble with circulation to the outer extremities, they had to amputate my left leg above the knee." She now is an associate in the university's science department, doing research on adult education.

The two stories are illustrative of the problem of sudden cardiac arrest in several ways, said Dr. Fritz A. Ehlert, director of the electrophysiology fellowship at Columbia University.

First, sudden cardiac arrest has to be distinguished from a heart attack, in which heart muscle dies when its blood supply is cut off. "Not everyone who has a heart attack develops sudden cardiac arrest, which is a rhythm disturbance," Ehlert said.

And while the risk factors for heart attack are well-known and easily detected -- high cholesterol, high blood pressure, obesity, diabetes -- sudden cardiac arrest is not as easily predicted. The risk is higher "for anyone why has had one in the past, who has a history of heart attack, who has heart failure, who has a family history of sudden cardiac arrest," Ehlert said.

Once it happens, seconds matter. "For every minute that goes by before therapy is initiated, survival decreases by 10 percent," Ehlert said. "The issue is always getting trained medical people to respond as quickly as possible."

The availability of external defibrillators is always a help, he said. Both Babcock and Stoltz now have implanted defibrillators, which deliver shocks automatically if the heart stops beating.

"It's in there, but you can't feel it," Babcock said.

More information

Causes, prevention and treatment of sudden cardiac arrest are described by the U.S. National Heart, Lung, and Blood Institute.

THURSDAY, Dec. 18 (HealthDay News) -- Many people who survive a subarachnoid hemorrhage stroke have a poor quality of life due to anxiety, depression and fatigue, Dutch researchers report.

A subarachnoid hemorrhage (SAH) stroke occurs when a blood vessel on the brain surface ruptures and bleeds into the space between the skull and the brain, but not into the brain. This study included 141 women and men, average age 51, living in the community two to four years after an SAH stroke.

Using the Stroke Specific Quality of Life scale, the researchers found that 32 percent of the survivors reported anxiety, 23 percent reported depression, and 67 percent reported fatigue. Overall, the best scores were in physical function, while the lowest scores were in emotional and social areas.

The study was published in the Dec. 19 online issue of Stroke.

"The major point is to look beyond physical symptoms and look at psychological symptoms and personality characteristics to evaluate quality of life. These characteristics are important to planning rehabilitation and targeting an intervention to help improve quality of life," study author Dr. Anne Visser-Meily, a rehabilitation specialist at the University Medical Center in Utrecht, said in an American Heart Association news release.

"When you analyze depression, anxiety and fatigue [in SAH survivors], you find there is a strong correlation with a passive coping style and neuroticism. Those with a passive coping style need psychological support to encourage them to be more independent," Visser-Meily said.

She and her colleagues also found that cognitive function is another important determinant of quality of life associated with coping style. Survivors were more likely to have neuropsychological problems if they had a passive coping style and were depressed.

"This emphasizes the need to take personality into account as a potential vulnerability factor for decreased QOL [quality of life]," Visser-Meily said.

A separate study also led by Visser-Meily found that coping is the most important predictor of psychological well-being of spouses of stroke survivors. The study, which included 211 stroke survivors and their spouses (average age 54), found that active coping strategies were associated with less stress and higher levels of participation, while a passive coping style was associated with negative outcomes.

While caregiver burden decreased significantly over time, 43 percent of spouses still scored above the cut-off point for burden three years after their partner's stroke. The study also found that the number of spouses with depressive symptoms decreased from 68 percent at the start of rehab to 53 percent at two months after rehab. But there was no further decrease in depressive symptoms, and there was a steady decline in relationship harmony and social relations.

"These findings highlight the need to monitor the long-term psychosocial functioning of the spouses of stroke patients as part of a family-centered approach," Visser-Meily said. "It is a very difficult job to be a caregiver. You not only have to manage the care of the stroke patient, you also have to take care of yourself. Not only burden, but also depressive mood, harmony in the relationship, and social relations need more attention in clinical practice."

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about post-stroke rehabilitation.

TUESDAY, Dec. 9 (HealthDay News) -- Cholesterol-lowering statin drugs don't interfere with rituximab, a medication used to treat lymphomas, say Mayo Clinic researchers, who also found that statins may actually slow progression of some kinds of lymphomas.

Rituximab is a monoclonal antibody often used alone or in conjunction with chemotherapy to treat lymphomas -- cancers of the lymph system. A study published earlier this year suggested that statins may inhibit rituximab's ability to bind to CD20, a protein found on lymphoma cells.

"That finding raised questions about maintaining or stopping cholesterol treatment with statins for patients with lymphoma," Mayo hematologist Dr. Grzegorz Nowakowski said in a clinic news release. "One in five lymphoma patients take cholesterol-lowering statins. This corresponds to the potential for thousands of patients at risk of getting less or ineffective treatment due to statin interference with therapy."

To clarify the issue, the Mayo team studied 228 patients with aggressive diffuse large B-cell lymphoma and 293 patients with slowly progressive follicular lymphoma. Twenty-two percent of the patients with diffuse large B-cell lymphoma and 19 percent of patients with follicular lymphoma were taking statins when they began treatment for their lymphoma.

Statin use didn't influence outcomes for patients with diffuse large B-cell lymphoma. Among the patients with follicular lymphoma, those taking statins actually had better outcomes. At two years, 80 percent of follicular lymphoma patients taking statins had no progression or re-treatment for their cancer, compared with 69 percent of patients not taking statins. This positive effect was observed regardless of the type of treatment: observation only; rituximab alone; or rituximab in combination with chemotherapy.

The study was expected to be presented Monday at the annual meeting of the American Society of Hematology, in San Francisco.

"These results can provide reassurance to oncologists and their patients that statins will not reduce the effectiveness of rituximab (brand name Rituxan) and may in fact improve outcomes of some patients with lymphomas," Nowakowski said.

More information

The Lymphoma Research Foundation has more about lymphoma  .

WEDNESDAY, Nov. 26 (HealthDay News) -- Expensive, high-tech CT devices that produce 64-slice images of arteries are almost, but not quite, as good as the standard method of detecting and gauging blood vessel blockages, a study finds.

Therefore, "multidetector CT angiography cannot replace conventional coronary angiography at present," concludes a report in the Nov. 27 issue of the New England Journal of Medicine.

But if that is so, experts ask, why is Medicare continuing to pay for these pricey CT exams?

"There is no evidence that they are of benefit to patients," said Dr. Rita F. Redberg, professor of medicine at the University of California, San Francisco, co-author of an editorial in the journal. "In general, there should be evidence of benefit before there is widespread use," she said.

Nevertheless, the study's lead author said the scans may have a place in cardiovascular care.

"Our study shows they do have value, because they have a high degree of diagnostic accuracy to identify patients with tight heart blockages," said Dr. Julie M. Miller, assistant professor of medicine at Johns Hopkins University. "Having the scan is a noninvasive procedure, and that is very attractive. Patients do not undergo the risk, even though it is small, of angiography."

Angiography, which requires insertion of a slim catheter tube into the blood vessels, is the typical way physicians gauge the degree of artery blockage to determine whether treatment is necessary. "Our paper shows for the first time that 64-CT scans can identify patients who need to go on to angioplasty and bypass procedures," Miller said. "It has diagnostic accuracy compared to other tests, such as stress testing. They create more invasive catheterizations than are needed than if the 64-CT test is used."

The study of 291 people with suspected coronary artery blockages was done at nine U.S. medical centers. They underwent both 64-CT and conventional coronary angiography.

The CT scans accurately predicted 84 percent of the treatment procedures that were required, compared to 82 percent accuracy for angiography.

"Until now, there has been doubt about 16-row or 64-row CT scanners being able to diagnose coronary disease," Miller said. The new study dispels that doubt, she said.

But there is no evidence that using a 64-CT scan changes the outcome, Redberg countered. "We need to have a study that uses CT and the traditional strategy and look at the outcome in the two arms to see which is better," she said.

This is more than an argument between academics. Aside from the health of people who might have CT scans, a great deal of money is involved. Redberg's editorial tells a tangled story of how the national Medicare program first declined coverage of the CT scans, asserting at the time that the "evidence is inadequate" to prove their value. However, a series of local decisions means Medicare now covers the scans in every state.

In fact, "the use of cardiac imaging has been increasing by 26 percent per year, despite a lack of evidence of outcome benefit," the editorial said. "Without such evidence, a high-resolution CT angiographic CT image of the heart is just another pretty picture," the expert said.

CT scans also expose patients to a relatively high dose of radiation, the editorial noted, citing a study which estimates that 1.5 percent to 2 percent of all U.S. cancer cases may be attributed to CT radiation.

However, Miller believes that CT scans do have a role in diagnosis.

"The cost to patients is generally reasonable when compared to other noninvasive imaging tests and cheaper than catheterization in general," she said. CT scans of the heart can be considered "for someone complaining of angina [chest pain] who needs further noninvasive evaluation, instead of a stress test, or patients who have had a previous stress test where the results were not clear."

More information

There's more on coronary angiography at the U.S. National Library of Medicine.