Automatic heart defibrillators saving lives

WASHINGTON (CNN) -- Heart-shocking machines installed in crowded places like airplanes and casinos can save dramatic numbers of people who suffer a cardiac arrest, according to a pair of studies.

The new automatic electronic defibrillators, or AEDs, saved nearly half of all victims involved in the two studies -- ten times the usual survival rate of five percent for people who suffer cardiac arrest outside a hospital.

The findings appeared in appear in Thursday's issue of the New England Journal of Medicine.

With increased use of AEDs, "it should certainly be possible for us to improve survival rates across the country to 20 to 30 percent," said Dr. Rose Marie Robertson, president of the American Heart Association. "That would save 50,000 lives a year."

There's no good place to have a heart attack, but one of the worst spots surely must be six miles up, in a jetliner.

Mike Tighe, who is in semi-retirement, has already seen the benefits. During a 1998 American Airlines flight from Boston to Los Angeles he suffered a heart attack on a plane equipped with an AED.

"Because it was used so quickly, because of the use of CPR, there was no deprivation of oxygen to my brain, so I really came out of this whole experience with no damage," explained Tighe.

His case was only one of 200 times that AED's were used onboard airliners or at airports between June, 1997 and July, 1999. One study found that their use boosted long-term survival rates to as high as 40 percent.

Another study in the journal looked at AED use by trained security personnel on nearly 150 patrons of casinos. It found survival rates as high as 74 percent, when AED's were used within three minutes of cardiac arrest.

AED's are fixtures on not just American, but Delta and United Airlines planes. They're also installed at Baltimore's BWI, Chicago's O'Hare and Midway fields and at Dallas-Fort Worth.

About 250,000 people in the United States die each year of cardiac arrest, which is usually caused by a heart rhythm disturbance called ventricular fibrillation, according to the heart association. For each minute that passes without a defibrillator shocking the heart back into a normal rhythm, the chance of surviving drops 10 percent.

Despite that, many police and fire department vehicles, ambulances and nursing homes are not equipped with the laptop-size devices, which give an EKG readout just like a hospital monitor and tell the operator whether the person needs a shock, how to apply the pads and when to press the button.

In one of the NEJM reports, researchers examined the use of AEDs from 1997 through 1999 by American Airlines, the first airline to put the devices -- and attendants trained to use them -- on every flight.

In 13 cases where the device indicated a passenger was in ventricular fibrillation and the person was shocked, every one was resuscitated. Forty percent survived to leave the hospital later, said the study's author, Dr. Richard L. Page, an associate professor of internal medicine at the University of Texas Southwestern Medical Center in Dallas.

"Those passengers would likely not have survived since it takes 20 minutes to land an aircraft and have a land-based crew resuscitate the patient," Page said.

The other NEJM study looked at defibrillator use by trained security personnel on nearly 150 patrons of casinos. It found survival rates as high as 74 percent when AEDs were used within three minutes of cardiac arrest.

The success of AED's has led to calls for them to be as commonplace as fire extinguishers in public places.

In May, President Clinton directed the Department of Health and Human Services and the General Services Administration to draft guidelines on setting up a program to place the defibrillators in every federal building, to train federal employees in their use and to coordinate with local emergency services.

The American Heart Association applauded the move and has agreed to help train federal workers to use the devices.

The newest models are about the same size and price of a laptop computer, use voice commands to lead users through each step and deliver an electric shock only if necessary.

Congress is considering legislation that would grant legal immunity to good Samaritans who use AED's, in public or private buildings, in an attempt to save lives.

CNN Correspondent Jonathan Aiken and the Associated Press contributed to this report.

The Associated Press contributed to this report.

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American Heart Association
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