November 15th, 2010
02:40 PM ET

AEDs don't extend life in hospitals

With heart disease remaining the leading killer in the United States, scientists are looking at ways to improve heart health.  Researchers presenting at this week's American Heart Association meeting  found that defibrillators in hospitals are not effective, a common heart imaging technique may expose patients to radiation and that an experimental pump can help heart patients who are waiting for transplants.

AEDs in hospitals not very effective

Automated external defibrillators help people when they’re outside the hospital – but don’t seem to help survival for people who are already hospitalized.

A study that will be published in the Journal of the American Medical Association this week found that using the AED lowered survival overall in the hospital.  This could be because only one in five hospitalized patients has the type of cardiac arrest that responds to defibrillation.

The findings were presented at the American Heart Association scientific sessions.  It assessed cardiac arrests in 204 U.S. hospitals between January 2000 and August 2008.  Of the 11,695 hospitalized patients. Only 18 percent had shockable rhythms compared with about 82 percent who had nonshockable rhythms.

The survival rate for patients in which the AEDs were not used was 19.3 percent – which was higher than 16.3 percent survival rate for patients in which the AED was used.

AEDs can improve survival when they’re in public places where large numbers of people gather.  But the evidence of its usefulness in hospital settings is mixed.

“Our results may appear surprising because AEDs have been shown to improve survival for witnessed out-of-hospital cardiac arrests in public locations. However, our results may differ substantially from those investigations due to differences in the initial cardiac arrest rhythm,” the authors wrote.

High radiation in heart diagnostic imaging

Patients who get multiple tests for a type of heart disease diagnostic imaging could be exposed to high radiation, according to another study presented at the heart group's annual meeting.

And high exposure to radiation could elevate risk of cancer.

The imaging test is called, myocardial perfusion imaging, which evaluates blood flow for scarring and to evaluate signs of heart disease.  In the study, which was conducted in 2006 at Columbia University Medical Center, 1,097 patients underwent MPI and 38.6 percent underwent additional MPI studies.

Repeated testing is associated with a high cumulative estimated radiation dose, according to the study, which will be published in this week’s Journal of the American Medical Association.

Heart pump shown to be effective

An experimental pump that assists patients with advanced heart failure waiting for a transplant can be effective, according to results of a clinical trial presented at the heart meeting.  

Among the 140 patients awaiting heart transplants, 92 percent of them survived for 180 days with the HeartWare device, and received a transplant or recovered to the point they no longer needed the device.

The device is a continuous-flow pump, implanted in the heart’s main pumping chamber with the remainder of the device positioned within the space surrounding the heart.

soundoff (7 Responses)
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  2. Fernando

    Maybe I'm missing something here, but the results are interpreted in a way that leaves important questions. Author submits that "using the AED lowered survival overall in the hospital." Lowered survival compared to what? Using a manual (not automated) defibrillator? Starting with nonelectrical therapies – e.g., meds? I had trouble locating article at "Scientific Sessions" which is currently in session, so hoping this author can clarify.

    November 16, 2010 at 11:34 | Report abuse | Reply
  3. andrew

    Great Article. My company, In Case Of Emergency, has put together a new HeartSafe AED Product package that comes with a HeartSine AED, alarmed wall storage cabinet, 3D AED wall sign, first aid kit, first aid/cpr/aed training for up to 12 people, and a 2 year AED management program all for the price of $1,895.00. There are also some other smaller accessories included in the package. Also check out the local Delaware County PA school AED video contest we have put together that kicks off January 1st, 2011. Check out our website http://www.iceems.com for the package info or give us a call!

    November 17, 2010 at 13:19 | Report abuse | Reply
  4. John Stewart RN, MA

    The study compared AEDs with manual defibrillators.

    This is a very important study. As a hospital nurse, I have long been concerned with the problem of delayed in-hospital defibrillation. It is really a HUGE problem, resulting in a few unnecessary deaths each year in just about every hospital. I believe the initial proportion of shockable rhythms is significantly larger than reported in this and other in-hospital studies, because delays in initial monitoring allow time to decay into flatline. The AHA made a big mistake years ago in tying early defibrillation in hospitals to purchase of AEDs–I tried to tell them then, but they didn't listen. The cynic in me says that AHA ties to the defibrillator makers was a factor.

    Anyway, I think it's feasible to train nurses to defibrillate effectively using any defibrillators you have. See my article at http://www.sjtrem.com/content/18/1/42.

    January 7, 2011 at 15:51 | Report abuse | Reply
  5. Greg

    I think AEDS are an important to have around. An AED actually saved my dads life and now i live by them.

    October 4, 2011 at 11:55 | Report abuse | Reply
  6. Yvonne

    An amazing revelaing about AED use iof true.

    "Automated external defibrillators help people when they’re outside the hospital – but don’t seem to help survival for people who are already hospitalized."

    I can't help but ask if this is due to;

    AED training?
    Does the "A study that will be published in the Journal of the American Medical Association this week found that using the AED lowered survival overall in the hospital. This could be because only one in five hospitalized patients has the type of cardiac arrest that responds to defibrillation." mean that 4 out of 5 having a cardaic event in non medical setting will respond to AED treatment?


    March 16, 2012 at 13:46 | Report abuse | Reply

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.

November 2010
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