{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:08:55Z","timestamp":1789013335490,"version":"build-2803163510"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,8,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Earlier defibrillation is a key factor in improving survival in patients with out\u2010of\u2010hospital cardiac arrest due to ventricular fibrillation. Although the benefit of public\u2010access defibrillation (PAD) has been reported, its effectiveness has rarely been evaluated considering intervention time. We assessed whether the effect of PAD varies depending on the timing of defibrillation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Using a nationwide, prospective, population\u2010based out\u2010of\u2010hospital cardiac arrest registry in Japan between 2022 and 2023, we included consecutive bystander\u2010witnessed ventricular fibrillation with resuscitation attempts in public locations. Patients with out\u2010of\u2010hospital cardiac arrest who received PAD before emergency medical services arrival were sequentially matched with patients at risk of receiving PAD on a minute\u2010by\u2010minute basis using time\u2010dependent propensity scores to address resuscitation time bias. The primary outcome was 1\u2010month survival with favorable neurological outcome, defined as a cerebral performance category scale of 1 or 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">After sequential matching, 1664 matched pairs were identified. The corrected risk ratio for 1\u2010month survival with favorable neurological outcome in the PAD group than in the non\u2010PAD group was 1.46 (95% CI, 1.34\u20131.59). The effect sizes by PAD timing were 1.33 (95% CI, 1.19\u20131.48) for 0 to 4\u2009minutes, 1.49 (95% CI, 1.30\u20131.70) for 5 to 9\u2009minutes, 1.55 (95% CI, 1.12\u20132.14) for 10 to 14\u2009minutes, 2.46 (95% CI, 0.83\u20137.30) for 15 to 19\u2009minutes, and 1.19 (95% CI, 0.29\u20134.85) after 20\u2009minutes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p xml:lang=\"en\">In Japan, among patients with bystander\u2010witnessed ventricular fibrillation in public locations, PAD before emergency medical services arrival was significantly associated with favorable neurological outcome, showing a directionally consistent association with improved outcomes regardless of time to emergency medical services arrival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.051586","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:16:51Z","timestamp":1785496611000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Timing of Public\u2010Access Defibrillation for Patients With Out\u2010of\u2010Hospital Cardiac Arrest: A Nationwide Cohort Study Using Time\u2010Dependent Propensity Score Sequential Matching Approach"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1497-6073","authenticated-orcid":false,"given":"Haruka","family":"Shida","sequence":"first","affiliation":[{"name":"The University of Osaka","place":["Suita, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1018-9508","authenticated-orcid":false,"given":"Yoshimitsu","family":"Shimomura","sequence":"additional","affiliation":[{"name":"The University of Osaka","place":["Suita, Japan"]},{"name":"The University of Osaka","place":["Suita, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6712-6930","authenticated-orcid":false,"given":"Atsushi","family":"Hirayama","sequence":"additional","affiliation":[{"name":"The University of Osaka","place":["Suita, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7492-6303","authenticated-orcid":false,"given":"Ryo","family":"Kawasaki","sequence":"additional","affiliation":[{"name":"The University of Osaka","place":["Suita, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sho","family":"Komukai","sequence":"additional","affiliation":[{"name":"Tokyo Medical University","place":["Tokyo, 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