Activation of community first responders did not improve short-term survival after cardiac arrest

A study presented at ESC Congress 2026 found that community first responders did not improve 30-day survival rates for patients experiencing out-of-hospital cardiac arrest. Executive Summary:

Community first responders, trained volunteers who assist during cardiac emergencies, were introduced in various countries. However, evidence supporting their use is based on observational studies, not randomized trials. To evaluate their impact, researchers conducted the HeartRunner trial in the Capital Region of Denmark, randomly assigning emergency calls for suspected cardiac arrest to either community first responder activation plus standard response or standard response alone.

Of the 2,060 patients analyzed, 30-day survival was identical whether community first responders were present or not. When responders arrived within three minutes, survival was 15% with activation compared to 17% without (p = 0.42). With a three to nine minute arrival time, survival was 13% with activation versus 14% without (p = 0.43).

Despite this lack of impact on survival, community first responder activation significantly increased bystander CPR and defibrillation rates. Specifically, bystander CPR rose from 75% to 86% (p < 0.0001) and defibrillation rose from 6% to 14% (p < 0.0001). However, the trial's short ambulance response times of around seven minutes suggest that the incremental survival benefit of community first responders may be limited in such scenarios.