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Use of AEDs in hospitals for cardiac arrest not linked with improved survival
Date:11/15/2010

While automated external defibrillators improve survival for out-of-hospital cardiac arrest, an analysis of data indicates their use for cardiac arrest in a hospital does not result in an improved rate of survival, according to a study in the November 17 issue of JAMA. The study is being released early online because it will be presented at the American Heart Association's annual meeting.

Use of automated external defibrillators (AEDs) has been proposed as a strategy to reduce times to defibrillation and improve survival from cardiac arrests that occur in the hospital setting, according to background information in the article. However, current evidence to support the use of AEDs in hospitals has been mixed and limited to single-center studies. Also, these devices may be less effective or potentially harmful when used in hospitals where only 1 in 5 hospitalized patients have initial cardiac arrest rhythms that respond to defibrillation. "Before the widespread dissemination of AEDs in hospitals, it therefore becomes critical to demonstrate that AED use improves survival," the authors write.

Using data from the National Registry of Cardiopulmonary Resuscitation, Paul S. Chan, M.D., M.Sc., of Saint Luke's Mid America Heart Institute, Kansas City, and colleagues evaluated the association of AED use and survival after an in-hospital cardiac arrest. The study included 11,695 hospitalized patients with cardiac arrests between January 1, 2000 and August 26, 2008, at 204 U.S. hospitals following the introduction of AEDs on general hospital wards. Of these patients, 2,079 (17.8 percent) had shockable rhythms, such as ventricular fibrillation or pulseless ventricular tachycardia (rapid heart rhythm), and 9,616 (82.2 percent) had nonshockable rhythms, such as asystole or pulseless electrical activity. AEDs were used to assess initial rhythm in 4,515 patients (38.6 percent).

Overall, 2,117 patients (18.1 percent) survived to hospital disch
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Contact: Kerry O'Connor
koconnor@saint-lukes.org
816-932-8646
JAMA and Archives Journals
Source:Eurekalert

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