Heart Defibrillators Do More Than Save Lives

Many treated with the devices resume normal routines

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By
HealthDay Reporter

(HealthDay is the new name for HealthScoutNews.)

WEDNESDAY, June 25, 2003 (HealthDayNews) -- The quick use of defibrillators to treat people in a heart crisis does more than save lives on the spot.

For many, it ensures a long-range return to normal routine, according to a new study in the June 26 issue of the New England Journal of Medicine.

Researchers tracked 200 people who had received emergency defibrillation. One hundred forty-two of them survived long enough to be admitted to the emergency room. Of those, 79 were eventually discharged from the hospital.

The five-year survival rate for those 79 people was identical to that of the general population. And a quality-of-life questionnaire given to 50 of them produced answers typical of healthy people their age, the study says.

Some complained of persistent feelings of weariness, but most were back at work. In fact, 65 percent of the survivors younger than 65 were working, the study found.

The research was done to confirm scattered reports of positive long-term results after emergency defibrillation, says Dr. Roger D. White, professor of anesthesiology at the Mayo Clinic in Rochester, Minn., and lead author of the report.

"We had not done an in-depth study of looking at the quality of life or survival compared to the normal population," he says. "I personally wasn't surprised about the results as others might be. I had a general idea that many of them had returned to normal lives, but we had not done this sort of assessment."

Dr. Vinay Nadkarni, associate professor of anesthesiology and clinical care at the University of Pennsylvania and a spokesman for the American Heart Association (AHA), calls the new findings "terrific news."

"It is really the information that has been needed to demonstrate that early, effective response to sudden cardiac arrest by defibrillation and cardiopulmonary resuscitation results in an excellent long-term outcome, including normal function and return to work," he says.

Defibrillation involves the use of a device that gives an electric shock to the heart. This helps reestablish normal contraction rhythms in a heart having dangerous arrhythmia or in cardiac arrest, according to the AHA.

The need for quick response, measured in minutes, was shown by the Mayo Clinic study. The average response time for defibrillation for survivors was 5.7 minutes; for those who didn't survive, it was 6.6 minutes.

In a related matter, a new poll found that only six percent of U.S. workplaces surveyed are equipped with portable defibrillators.

The poll, by RoperASW and Philips, also found that 53 percent of workplaces that currently have portable defibrillators said they'd recommend that other companies have portable defibrillators on site.

White says he promoted a defibrillator strategy for Rochester. "Our purpose was not to place defibrillators at a whole variety of public sites where there might be over-saturation, but to make them widely available in police cars," he says. "My assumption was that they would be able to respond quickly enough."

That strategy has been adopted by the city of Amsterdam in the Netherlands and by several American cities, White says. "Lots of police departments are doing it, but none have reported results, which to me is very disappointing," he says.

The American Heart Association says defibrillators should be available in public places where large numbers of people are found, such as airports.

To Nadkarni, the new report is final proof of the value of swift response to cardiac arrest.

"There were many reports where early, effective defibrillation resulted in high rates of hospital admission, hospital discharge and good quality of life," he says. "Now we can add the link of rehabilitation and return to normal function. All the links of the chain are in place."

More information

You can get official recommendations about emergency defibrillation from the American Heart Association. The National Heart, Lung, and Blood Institute has details on the warning signs of a heart attack.

SOURCES: Roger D. White, M.D., professor of anesthesiology, Mayo Clinic, Rochester, Minn; Vinay Nadkarni, M.D., associate professor of anesthesiology and clinical care, University of Pennsylvania, and spokesman, American Heart Association; June 26, 2003, New England Journal of Medicine

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