Thu, Nov 13, 2003 - Page 7 News List

Public defibrillators help survival rate of heart attack victims

NY TIMES NEWS SERVICE , ORLANDO, FLORIDA

People in cardiac arrest are twice as likely to survive in places where defibrillators are publicly available and volunteers have been trained to use them, according to a study reported Tuesday at a meeting of the American Heart Association.

The study was one of several presented this week that found that the devices worked well even when used by people who had only brief training. While earlier studies have indicated that the use of defibrillators by volunteers is safe, the new studies are among the first to find actual improvement in survival after wider distribution of defibrillators.

Another study presented here showed that most survivors of a cardiac arrest did not suffer cognitive impairment, even if a relatively long time had passed before a defibrillator was used to restore the heartbeat.

But it was not all good news at the meeting. Another study found that the chances of a patient being resuscitated from a cardiac arrest in a hospital were lower if the event occurred on the night shift as opposed to the day and evening shifts.

Doctors have trained many police, fire, airline and other workers to use defibrillators as the devices have become standard equipment in many airports, malls, convention centers and health clubs.

Still, more than 1,200 people die from cardiac arrest each day in the US before they can be admitted to a hospital. The survival rates vary widely depending on the geographic area, in part because of the time it takes for emergency medical technicians to reach victims. The vast majority die before reaching a hospital.

Because an electrical shock to the heart is the only chance for survival for many such people, the heart association and health officials have made extensive efforts in recent years to distribute automated external defibrillators in public places.

The National Heart, Lung and Blood Institute, a federal agency in Bethesda, Maryland, paid for a study in which about 1,500 defibrillators were put in 993 malls, centers for the elderly and other community sites in 24 cities in the US and Canada.

The study organizers had nearly 20,000 volunteers take a two-to-four-hour course. Half were taught to compress the chest as part of cardiopulmonary resuscitation; the other half were taught to use defibrillators.

Over 21 months, 232 people suffered cardiac arrests, and 44 survived. Of those, 29 had received shocks from defibrillators and 15 had only received CPR.

Dr. Raymond Gibbons of the Mayo Clinic, the chairman of the heart association's scientific committee, said that wider use of defibrillators would "potentially have an enormous impact" by saving lives from cardiac arrest.

A different one-year study of 76 health clubs in Great Britain with defibrillators found that using them along with CPR saved the lives of six of eight people who suffered sudden cardiac arrest, reported a team headed by Dr. Kyle McInnis.

The clubs had nearly 50,000 adult members and screened new members for heart problems. Of the eight victims, who were aged 47 to 76, only one was known to have had heart disease. All were exercising at the time of sudden cardiac arrest.

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