E.R. doctors talk about a "golden hour" after someone suffers a heart attack or stroke, during which prompt medical attention can lead to complete or nearly complete recovery. But when it comes to cardiac arrest, in which the heart's electrical signals become so disorganized that it can no longer pump blood, that precious window is reduced to just a minute or two. For each minute that the heart is not shocked, or defibrillated, back to normal, a person's chance of survival drops 10%. After 10 minutes, the chances of survival--not to mention recovery--shrink to nearly zero.
Those long odds got a boost last week when the FDA approved the first consumer-friendly device designed to restart hearts in the home, where 70% of cardiac arrests occur. The HeartStart Home Defibrillator, manufactured by Philips Electronics, is similar to other so-called automated external defibrillators (AEDs) that you may have seen in casinos or airports. The machines deliver the same electrical shock as those paddles doctors use in the hospital--and without which no medical television show worth its Nielsens could long survive.
TV dramas aside, AEDs are marvels of medical engineering. They test the signals coming from a patient's heart for the type of electrical problem that responds to defibrillation, and they're smart enough not to deliver a shock unless they find the right signal, thus preventing accidental discharge. Although untrained passersby have successfully used AEDs, the ideal user is someone who has undergone a four-hour training course on how to give cardiopulmonary resuscitation (CPR) and operate an AED. CPR by itself does not usually revive someone in cardiac arrest, but it can keep a person alive for the critical extra few moments needed to locate and hook up the AED.
Some caveats should be kept in mind. You need a physician's prescription to get a home AED, and because cardiac arrest quickly leads to a loss of consciousness, you cannot use one on yourself. Also, in the rush to find the AED, family members might forget to call 911, which the American Red Cross and the American Heart Association both stress should always be the first step. And at $2,295, the HeartStart isn't cheap, which raises questions about how cost effective their widespread use may be. The National Institutes of Health is sponsoring several studies to look into these and other issues.
Until then, it's hard to say who will benefit most from having an AED at home. Certainly those folks with a history of heart disease or heart attack are good candidates. And then there are people like Lee Curtes, 57, a businessman from Hartford, Wis., who had no idea there was anything wrong with his heart until he collapsed on a ski slope three years ago. An AED operated by the ski patrol helped save his life. Since then, Curtes has kept one in his car, hoping someday to help another heart in need.
For more information on AEDs, visit www.early-defib.org